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Galeazzi Fracture
From WikiSM
Contents
Other Names
- Galeazzi Fracture-Dislocation
- Distal radius fracture dislocation
Background
- Defined as fracture of the distal third of the Radius and a dislocation of the Distal Radial Ulnar Joint (DRUJ)
History
- First described by Cooper in 1822
- Took eponym of Riccardo Galeazzi in 1934 when he described mechanism, incidence and management
Epidemiology
- Bimodal incidence (need citation)
- Young males 10 in 10,000
- Elderly females 5 in 10,000
Pathophysiology
Mechanism
- Typically the result of a fall on outstretched hand (FOOSH) with extended wrist, pronated forearm[1]
- Bracing with an outstretched hand during a motor vehicle collision
- Low energy trauma in elderly females, e.g. fall from ground level
Risk Factors
- Sports
- Football
- Wrestling
- Osteoporosis
- Menopause
Differential Diagnosis
- Fractures
- Pediatric Specific Fractures
- Dislocations & Instability
- Soft Tissue Trauma
- Tendinopathies
- Neuropathies
- Pediatric Considerations
Clinical Features
- History
- Description of mechanism
- Wrist pain, deformity
- Physical Exam: Physical Exam Forearm
- Tender over fracture site with swelling, bruising, deformity
- DRUJ Compression Test: Assess integrity of DRUJ
Evaluation
Radiographs
- Standard Radiographs Forearm
- Findings
- Widening of DRUJ (PA)
- Ulnar styloid fracture
- Dorsally displaced ulna (lateral)
- Shortening of radius
CT
- Indications
- Preoperative planning
MRI
- Indications
- Evaluate soft tissue injuries
Classification
OTA classification of radius/ulna
- 22-A2.3: Simple fracture of radius with dislocation of DRUJ[2]
- 22-A3.3: Simple fracture of both bones (distal zone radius) with dislocation of DRUJ
- 22-B2.3: Wedge fracture of radius with dislocation of DRUJ
- 22-B3.3: Wedge of both bones with dislocation of DRUJ
Management
Acute Management
- Closed reduction
- Rest, ice, elevation
- Immobilization: Sugar Tong Splint
- Orthopedic consultation
Nonoperative
- Indications
- Successful closed reduction
- Pediatrics
- Good outcomes with nonoperative management
- Cast: Long Arm Cast
- Adults
- Do not do as well with conservative management and considered a surgical problem
Operative
- Indications
- Adult Galeazzi fracture
- Unstable pediatric fracture
- Technique
- ORIF radius
- Stabilization of DRUJ
Return to Play
- Highly variable and surgeon discretion
- Requires rehabilitation post operatively
- Low activity 8-12 weeks, work and sports 12-16 weeks
Complications
- Acute Compartment Syndrome
- Neurovascular injury
- Nonunion
- Malunion
- Distal Radioulnar Joint Instability
See Also
References
- ↑ Tsismenakis T, Tornetta P. Galeazzi fractures: Is DRUJ instability predicted by current guidelines? Injury. 2016 Jul;47(7):1472-7.
- ↑ https://www.orthobullets.com/trauma/1029/galeazzi-fractures