Is the John Thomas Sign a Finding Indicating the Direction of a Pelvis Fracture?

Year 2024, Volume: 14 Issue: 1, 14 - 18, 30.04.2024

Emre Karslı , Murat Aras

Abstract

Introduction: The John Thomas (JT) sign is defined as the penis showing the direction of the fracture in hip or pelvic fractures in male patients. The sensitivity and specificity values of the John Thomas sign vary widely in studies.
Materials and Methods: Male patients over the age of 18 who applied to the Emergency Department of the Faculty of Medicine of Kafkas University between 01.01.2015 and 14.10.2020 due to trauma and who had pelvic tomography were included in the study. The study included 118 male patients who had fractures in the pelvis, proximal femur, and femoral shaft as a result of tomography and 73 male individuals who applied for trauma and had pelvic tomography but did not have any abdominal, pelvis, or lower extremity injuries. The penis angle was recorded as the intersection angle of the vertical line drawn from the symphysis pubis and the line drawn from the midline of the penis corpus cavernosum to the tip of the penis. The study did not include individuals with pelvic asymmetry and those with previous pelvic surgery.
Results: The mean age of the patient group was 45.2±6.4 years, and the mean age of the control group was 44.9±5.9 years. There was no statistically significant difference between the mean ages of the groups (p=0.557. While 52 (83.9%) of 62 patients with fractures on the left side of the pelvis had positive JT sign, 37 (66.1%) of 56 patients with right-side fractures had positive JT sign. There was a moderate correlation between fracture and penile direction in the patient group (p=0.0001, rho=0.509).
Conclusion: As a result of our study, it was determined that the John Thomas sign alone is not sufficient to detect pelvic fractures, but it can help to diagnose patients with pelvic trauma and suspected fractures.

Keywords

John Thomas sign, Throckmorton sign, pelvic fractures, Solooki sign

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