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Chauffers Fracture
From WikiSM
(Redirected from Chauffer's Fracture)
Contents
Other Names
- Chauffeur's Fracture
- Hutchinson Fracture
- Backfire Fractures
Background
- This page refers to Chauffer's fracture which is defined as an itra-articular fracture of the radial styloid process
History
- Name related to started a hand crank car which would occasionally result in the crank rapidly spinning backwards out of the driver's grasp and striking the back of the wrist
Epidemiology
- Prevalence, incidence poorly defined in the literature
Pathophysiology
- Anatomy
- Mechanism
- Direct blow to the back of the wrist
- Forced dorsiflexion with abduction
- Potential co-occurring injuries
Risk Factors
Differential Diagnosis
Distal Radius Fractures
- Barton's Fracture
- Chauffer's Fracture
- Colles' Fracture
- Die-Punch Fracture
- Radial Styloid Fracture
- Smith's Fracture
Differential Diagnosis Wrist Pain
- Fractures
- Dislocations
- Wrist Dislocation (Radiocarpal and/or Ulnocarpal)
- Carpometacarpal Joint Dislocation
- Distal Radioulnar Joint Dislocation
- Lunate Dislocation
- Perilunate Dislocation
- Instability & Degenerative
- Tendinopathies & Ligaments
- Neuropathies
- Pediatric Considerations
- Distal Radial Epiphysitis (Gymnast's Wrist)
- Torus Fracture
- Arthropathies
- Cartilage
- Vascular
- Other
Clinical Features
- General: Physical Exam Wrist
- Pain, swelling, ecchymosis in wrist
- Deformity may or may not be present depending on degree of displacement
Evaluation
Radiographs
- Standard Radiographs Wrist initially
- Sufficient to make diagnosis
- Fracture typically extends through lateral cortex of distal radius separating radial styloid
- Fracture fragment may not be displaced
CT Scan
- Evaluate for intra-articular involvement, surgical planning
MRI
- Evaluate for concurrent soft tissue injuries
Classification
- Exists, although not commonly used
Management
Nonoperative
- Acceptable closed reduction
- < 2mm articular stepoff
- < 5mm shortening
- < 10° dorsal tilt
Operative
- Surgical Indications
- Radial shortening > 3 mm
- Dorsal tilt > 10º
- Intra-articular displacement
- Step-off > 2 mm
Return to Play
- Needs to be updated
Complications
- Median Nerve Neuropathy
- Ulnar Nerve Neuropathy
- EPL Rupture
- FPL Rupture
- Radiocarpal Arthropathy
- Malunion or Nonunion
- ECU or EDM Entrapment
- Acute Compartment Syndrome
- RSD/ CRPS
- Distal Radioulnar Joint Disruption
- TFCC Injury
- Scapholunate Instability (DISI)
- Lunotriquetral Instability (VISI)
See Also
- Internal
- External
- Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/