Monday, August 8, 2011

The lost romance of broken bones!

It's not surprising that many people feel disconnected from medicine these days: a great deal of the "romance" seems to have gone out of it! I was ruminatinig on this thought whilst keeping up to date on the latest ideas involving how best to manage broken bones.

There was a time when a broken wrist was called a Colles Fracture - after a famous Irish surgeon in the early 19th century, who described the clinical presentation of such injuries long before the invention of Xrays. A Colles fracture classically occurs when someone trips, and falls with their arms out-stretched in front of them, leaving a "dinner fork"deformity caused by the fracture! Now that's something we can all understand and relate to: but the modern terminology is a DRF - or Distal Radial Fracture!

DRF has now "consumed" another lesser known, but equally colourful wrist fracture, the Chauffeurs Fracture! Back in the days before electronic ignition for motor cars, the driver -and in more affluent society, this meant the Chauffeur - had to start the motor with the use of a "Crank" handle. With a hefty turn of the handle, the motor usually spluttered into life. However, it was very important to be very careful, otherwise the engine had a nasty habit of giving a "kick" backwards: this caused the handle to fly back over and fetch the back of your wrist a mighty clout, leading to an almost dinner spoon deformity!

Then there were the Game-Keepers thumbs: these injuries were originally described by a Doctor Cambell in 1955, and arose frequently in Scottish game-keepers who dispatched their rabbits to their eternal reward, by gripping the neck of the poor, furry beast, between finger and thumb and then breaking it! This, naturally, dispatched the bunny, but also lead to injuries to the perpetrators thumbs because of the violence of the action. Ligaments ruptured and bone flakes were torn off bones. Today, our experts talk of "an insufficiency of the ulnar collateral ligament (UCL) of the metacarpophalangeal (MCP) joint of the thumb": where's the romance in that!

I suppose that the upside to this loss of colourful names, is a massive improvement in our ability to accurately diagnose and treat these fractures; and to treat them appropriately according the the relevant situations of the person attached to them.

Ampersands & angle brackets need to be encoded.

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