Between these two injuries there is too great a dissimilarity to admit of an excuse for the surgeon who mistakes the one for the other but he may confound with these and it is a common fault to do so, a subluxation of the wrist, consequent to a fracture through the articular surface of the carpal extremity of the radius although to this accident belong appearances exclusively its own. In complete dislocations, the nature of the injury must always be very palpable from the great bulging of the overlapped bones and from the shortening of the limb, etc. It is not marked by any abrupt and solid eminences, the swelling is rather uniform, diffuse and puffy, the hand continues on the same line with that of the forearm, etc. In simple sprains of the wrist, though accompanied by extreme swelling, the limb will still be found to retain a characteristic outline of its natural contour. It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine.1838 – John Rhea Barton described a ‘ subluxation of the wrist consequent to a fracture through the articular surface of the carpal extremity of the radius.’ in his publication Views and treatment of an important injury of the wrist. It is also known as backfire fracture or lorry driver fracture 1. Its other names derive from the typical occupation of people who sustained this injury due to direct trauma from starting a car with a crank. It was originally named by British surgeon Jonathan Hutchinson (1828-1913). ulnar styloid fracture: equates to a Frykman type IV fractureĪlthough these fractures are often undisplaced, they are relatively unstable and often benefit from percutaneous lag-screw fixation 6.scapholunate dissociation: this is especially true when the fracture line involves the articular surface near the scapholunate interval 7. Although often the fracture is undisplaced 5, depending on how sagittal the fracture orientation is, variable proximal migration of the fracture occurs, with an articular step which comes into contact with the scaphoid 4.Ī number of associated injuries are frequently encountered and may significantly impact on management: The fracture extends proximally in a variable oblique direction (from essentially transverse to almost sagittal) from the distal radial articular surface through the lateral cortex of the distal radius, thus separating the radial styloid from the rest of the radius 4,5. Chauffeur fractures are considered type III fractures. Along with other distal radial fractures, the AP film can also be used to classify these fractures according to the Frykman classification of distal radial fractures. Plain films usually suffice in the assessment of chauffeur fractures. The latter occurs as the scaphoid forcibly impacts upon the radial styloid and can be considered an avulsion fracture with the radiocarpal ligaments remaining attached to the radial styloid 7. The former accounts for its name trying to start an old-fashioned car with a hand crank sometimes resulted in the crank rapidly spinning backward (backfire) out of the driver's grasp and striking the back of the wrist 5. These injuries are sustained either from direct trauma typically a blow to the back of the wrist or from forced dorsiflexion and abduction.
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