Many people consider the Galeazzi and Piedmont fractures as the same injury. History and etymologyįirst described in 1934 by Italian orthopaedic surgeon Riccardo Galeazzi (1866-1952) 1,2. In Galeazzi-equivalent fractures, ulnar physeal arrest is frequent, seen in 55% of cases. distal radioulnar joint now stable: immobilisation in supination in an above-elbow cast is indicated 7.distal radioulnar joint remains unstable: by triangular fibrocartilage complex exploration and repair followed by Kirschner wire fixation of the ulna to radius and immobilised in supination in an above-elbow cast.irreducible: further exploration of the distal radioulnar joint with the view to release interposition and post-release re-assessment of the distal radioulnar joint:.reduced and unstable with large ulnar styloid fragment: open reduction and internal fixation of the ulnar styloid followed by immobilisation in an above-elbow cast 7.reduced and unstable with no ulnar styloid fragment: Kirschner wire fixation of the ulna to the radius, triangular fibrocartilage complex exploration and repair if necessary and immobilisation in supination in an above-elbow cast 7. reduced and stable: splint and early motion 7.Open reduction of the radial shaft fracture and internal fixation with a dynamic compression plate and screws may also reduce the distal radioulnar joint dislocation 7.įollowing intraoperative assessment of the distal radioulnar joint, the reducibility and stability of the joint determines the indicated treatment: Galeazzi fracture-dislocations are unstable requiring surgical intervention, which involves open reduction and internal fixation (ORIF) of the radial fracture, intraoperative assessment of the distal radioulnar joint for reducibility and stability, and subsequent Kirschner wire fixation of the ulna to the radius, triangular fibrocartilage complex (TFCC) exploration and repair, and splinting or immobilisation in supination via an above-elbow cast 7. In addition to stating the presence of the radial fracture and distal radioulnar joint dislocation, a number of features should be sought and commented on: asymmetry of the distal radioulnar joint when compared to the other forearm 6.widening of the distal radioulnar joint on the frontal view 6.radial shortening may occur, and if greater than 10 mm, suggests complete disruption of the interosseous membrane.dislocation of the distal radioulnar joint.commonly at the junction of the middle and distal thirds.However, good quality orthogonal views are needed to identify and characterise displacement correctly. Galeazzi fractures are classified according to the direction of radial displacement:Ī forearm series is usually sufficient for diagnosis and management planning. Typically, Galeazzi fracture-dislocations occur due to a fall on an outstretched hand (FOOSH) and result in dorsal displacement of the radius (type I) if the axial load was applied to the forearm in supination or volar displacement of the radius (type II) if the forearm was in pronation 7. Galeazzi fractures are primarily encountered in children, with a peak incidence at age 9-12 years 3. In adults, it is estimated to account for ~7% of forearm fractures 3.
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