[What wrist fracture did Pouteau actually describe?].
The so-called " Pouteau-Colles" fracture was never specifically described by Pouteau. This surgeon from Lyons wrote a paper published in his posthumous works in 1783. The author was allowed access to an original edition of the paper at the "Ancienne Ecole de Médecine Navale de Rochefort". When reading this paper, it seems that Pouteau described a great variety of different kinds of forearm fractures. His original contribution was to define the mechanism of injury as occurring during a fall on the outstretched hand as opposed to direct injury. Pouteau presents a hypothetical muscular theory of fracture pattern etiology, but one that is useful in the understanding of the displacemnt of the bone fragments. He questions the principal role attributed to sprains and luxations at this time in the differential diagnosis of forearm injury. He described four clinical signs to diagnose, at a glance, which bone was injured, the site of the fracture, its displacements and mechanism of inury. Pouteau also presented a precise method of reduction and an original system of immobilisation, able to accomodate secondary displacements and avoid complications that were not fully recognised at that time, namely compartment syndrome and nosocomial infection. Pouteau simply concludes with a question concerning the future methods needed to reduce bony collapse and to fill the bone defects. In order to render special homage to this visionary surgeon, the author propose to attribute to the nosologic entity "fore-arm bone fractures" the qualificative of "Pouteau's fractures", or to associate to every fracture of the fore-arm described by any other author the name of the Lyons surgeon!
Liverneaux
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Service d'orthopédie, hôpital Saint-Charles, rue du Docteur-Peltier 17301 Rochefort-sur-Mer, France. p.liverneaux@tiscali.fr
D003100:Colles' Fracture / Q000266:history*; D005602:France; D049671:History, 18th Century; D006801:Humans; D019637:Orthopedic Procedures / Q000266:history*; D011885:Radius Fractures / Q000266:history*