40 - chauffeur's fracture

Hutchinson, chauffeur's, or radial styloid fracture

The chauffeur's fracture derives its name from injuries that were acquired, in the days when motor vehicles were cranked, when a vehicle backfired. The force is described as a direct axial compression of the scaphoid into the radial facet. The radial styloid is fractured, with associated avulsion of the radial collateral ligament.^{3, 2} A chauffeur's fracture represents an avulsion related to the attachment sites of the radiocarpal ligaments or of the radial collateral ligament. Scapholunate dissociation and lesser arc injuries of the wrist may be indicated by a fracture line on the radial articular surface between the scaphoid and lunate fossae.

The PA view usually demonstrates the lesion. Wood and Berquist report that little or no abnormality is seen on lateral views.²

Chauffeur's fractures are classified as simple or comminuted radial styloid fractures and as displaced or nondisplaced fractures. These injuries show no evidence of carpal subluxation.

Complications include scapholunate dislocation, osteoarthritis, and ligamentous damage.