Imaging Case of the Week 502 Answer

The wrist x-ray shows 2 injuries. Radial styloid fracture (Chauffeur’s fracture) & scapholunate dissociation (Terry Thomas Sign).

Chauffeur’ s fracture is named after its occupational origin; during olden days, chauffeurs and cab drivers sustained this fracture while trying to start an old fashioned car with a hand crank.

Associated injuries are – scapholunate dissociation (as in the above x-ray), lunate dislocation, dorsal Barton’s fracture.

While assessing wrist x-rays, if a fracture is identified, keep looking for other injuries. In the x-ray shown, identification of radial styloid injury alone without diagnosing associated scapholunate dissociation can lead to mismanagement of the injury.

Further reading