Presentation
Patient presents to the emergency department with left wrist pain after a fall on pavement.
Patient Data
There is an acute, minimally displaced and intra-articular fracture of the radial styloid.
Case Discussion
Acute intra-articular fracture of the distal radial styloid compatible with a Chauffeur or Hutchinson fracture.
This was first observed and reported as an occupational injury of chauffeur's by Dr. Lucas-Championniere and later published by Dr. Lund in 1904 as:
"A violent twisting backward of the hand at the wrist, without the impacting force which is present in the ordinary Colles’s fracture . . . In the fracture from the ‘back kick’ of the starting handle, there is no impaction or splintering. The hand is violently dislocated backward, and the ligaments at the wrist simply tear off the articular surface close to the lower end of the bone, commonly just above the base of the styloid process. The line of fracture is clean and transverse, there is no impaction or splintering, and the deformity, if present, is easily reduced."
Thought it may also be caused by a direct blow from the starting handle.
The first description of the fracture was actually done by Dr. Hutchinson in 1866, in his article, “Original Lectures: Notes on Some of the More Rare Form of Fractures and Dislocation” (1866), but not in the setting of an occupational injury.
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