The Use of Eponyms for Surgical Approaches and Fractures in Elbow Surgery: Accuracy and Reliability Pre- and Post-Training



1 Upper Limb Unit, Department of Orthopedic Surgery, Amphia Hospital, 4818 CK Breda, The Netherlands

2 Department of Orthopedic Surgery, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands

3 Foundation for Orthopedic Research, Care & Education, Amphia Hospital, 4818 CK Breda, The Netherlands

4 Shoulder and elbow Unit, Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, 1091 AC Amsterdam, The Netherlands

5 Upper Limb Unit, Department of Orthopedic Surgery, Amphia Hospital, 4818 CK Breda, The Netherlands Department of Orthopedic Surgery, University of Amsterdam, 1105 AZ Amsterdam-Zuidoost, The Netherlands

6 Department of Surgery and Traumatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands

7 Department of Orthopedic Surgery, Flinders Medical Centre, Adelaide, Australia


The use of eponymous terms in orthopedic trauma surgery is common. In an assessment pre-training versus posttraining
at an AO Advanced Elbow Trauma Course, we aimed to report on (1) the accuracy and (2) reliability of 10
common eponymous terms used for surgical approaches and fractures in elbow surgery. Before training, eponyms
were described correctly in 38% of questions versus 47% after training. The percentage of correct answers only
improved significantly in one question (P<0.005). A generalized kappa of 0.37 before training versus 0.31 after
training represents an overall fair reliability of the eponymous terms. In conclusion, the accuracy and reliability
of eponymous terms used in elbow surgery is disappointing. Moreover, this type of standardized training format
does not seem to improve the knowledge of eponymous terms of experienced trauma- and orthopedic surgeons.
Therefore, we suggest considering descriptive terms or standardized fracture classifications instead of eponymous
Level of evidence: II


Main Subjects

1. Somford MP, Hoornenborg D, Wiegerinck JI, Bolder
SB, Schreurs BW. Eponymous hip joint approaches.
Arch Orthop Trauma Surg. 2016; 136(7):1007-14.
2. Somford MP, Wiegerinck JI, Hoornenborg D, van den
Bekerom MP, Eygendaal D. Eponyms in elbow fracture
surgery. J Shoulder Elbow Surg. 2015; 24(3):369-75.
3. Somford MP, Nieuwe Weme RA, Sierevelt I, Doornberg
JN, Niek van Dijk C, Ring D, et al. The reliability of
orthopaedic eponymous terms. J Bone Joint Surg Am.
2017; 99(13):e70.
4. Somford MP, Nieuwe Weme RA, van Dijk CN, FF IJ,
Eygendaal D. Are eponyms used correctly or not? A
literature review with a focus on shoulder and elbow
surgery. Evid Based Med. 2016; 21(5):163-71.
5. Garfield E. What’s in a name? The eponymic route to
immortality. Essays Inform Sci. 1983; 6(21):384-95.
6. Baskaran LN, Greco PJ, Kaelber DC. Case report
medical eponyms: an applied clinical informatics
opportunity. Appl Clin Inform. 2012; 3(3):349-55.
7. Fox RJ. Defending eponyms. Arch Neurol. 2006;
8. Somford MP, de Visser E, Ijpma FF. The origins and 
current applications of classic eponymous terms for
pelvic and acetabular fractures: a historic review. J
Trauma Acute Care Surg. 2017; 82(4):802-9.
9. Waseem M, Khan M, Hussain N, Giannoudis PV, Fischer
J, Smith RM. Eponyms: errors in clinical practice and
scientific writing. Acta Orthop Belg. 2005; 71(1):1-8.
10. Ravitch MM. Dupuytren’s invention of the Mikulicz
enterotome with a note on eponyms. Perspect Biol
Med. 1979; 22(2 Pt 1):170-84.
11. Smith RM. The classification of fractures. J Bone Joint
Surg Br. 2000; 82(5):625-6.
12. Makhmalbaf H, Shahpari O. Medial collateral
ligament injury; a new classification based on mri
and clinical findings. A guide for patient selection and
early surgical intervention. Arch Bone Jt Surg. 2018;
13. Landis JR, Koch GG. The measurement of observer
agreement for categorical data. Biometrics. 1977;
14. Kocher ET, Stiles HJ. Textbook of operative surgery.
London: Adam and Charles Black; 1895.
15. Kaplan EB. Surgical approach to the proximal end of
the radius and its use in fractures of the head and neck
of the radius. J Bone Joint Surg Am. 1941; 23(1):86-92.
16. Henry AK. Complete exposure of the radius. Br J Surg.
1926; 13(51):506-8.
17. Boyd HB. Surgical exposure of the ulna and proximal
third of the radius through one incision. Surg Gynecol
Obstet. 1940; 71(1):87-8.
18. Hotchkiss RN, Kasparyan NG. The medial ‘‘over
the top’’ approach to the elbow. Tech Orthop. 2000;
19. Monteggia GB. Lussazioni della ossa delle estremita
superiori. 2nd ed. Milan: Instituzioni Chirurgisches;
1814. P. 131-3.
20. Galeazzi R. Di una particolare sindrome traumatica
dello scheletro dell’avambraccio. Atti Mem Soc Lomb
Chir. 1934; 2(12):663-6.
21. Essex-Lopresti P. Fractures of the radial head with
distal radio-ulnar dislocation; report of two cases. J
Bone Joint Surg Br. 1951; 33B(2):244-7.
22. Hahn NF. Fall von einer besonderen varietat der
frakturen des ellenbogens. Zeitschrift Wundarzte
Geburtshelfer. 1853; 6(1):185-9.
23. Steinthal D. Die isolierte fraktur der eminentia
capitata im ellenbogengelenk. Zentralbl Chirurgie.
1898; 15(1):1.
24. Osborne G, Cotterill P. Recurrent dislocation of the
elbow. J Bone Joint Surg Br. 1966; 48(2):340-6.
Volume 7, Issue 2
March and April 2019
Pages 191-198
  • Receive Date: 13 July 2018
  • Revise Date: 27 August 2018
  • Accept Date: 28 August 2018
  • First Publish Date: 01 March 2019