Galeazzi fracture-dislocation: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
*PA: May only show slightly increased distal radioulnar joint space | *Inspect skin for signs of open fracture | ||
*Lateral: Ulna is displaced dorsally | *Assess distal pulses, motor, and sensation | ||
*Imaging: Plain radiographs | |||
**PA: May only show slightly increased distal radioulnar joint space | |||
**Lateral: Ulna is displaced dorsally | |||
[[File:Galeazzi fx.jpeg|thumb|Galeazzi Fracture]] | [[File:Galeazzi fx.jpeg|thumb|Galeazzi Fracture]] | ||
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*[[Long arm posterior splint]] with elbow flexed 90° and forearm '''pronated''' | *[[Long arm posterior splint]] with elbow flexed 90° and forearm '''pronated''' | ||
**Linked image indicates neutral position of forearm, rather than pronation | **Linked image indicates neutral position of forearm, rather than pronation | ||
*Pediatrics: | |||
**Can manage with closed reduction if DRUJ stable after splinting | |||
==Disposition== | ==Disposition== | ||
*If splinted and stabilized, can be discharged after consultation with Ortho | *If splinted and stabilized, can be discharged after consultation with Ortho | ||
Revision as of 16:46, 14 March 2018
Background
- Radius fracture (distal third) + distal radioulnar dislocation
- Concurrent Ulnar Styloid fracture is common
- Caused by FOOSH with flexed elbow or direct blow
- Arm equivalent of a Maisonneuve fracture
Clinical Features
- Localized tenderness/swelling over distal radius/wrist
Differential Diagnosis
Forearm Fracture Types
- Distal radius fractures
- Radia ulna fracture
- Isolated radius fracture (proximal)
- Isolated ulna fracture (i.e. nightstick)
- Monteggia fracture-dislocation
- Galeazzi fracture-dislocation
- Forearm fracture (peds)
Evaluation
- Inspect skin for signs of open fracture
- Assess distal pulses, motor, and sensation
- Imaging: Plain radiographs
- PA: May only show slightly increased distal radioulnar joint space
- Lateral: Ulna is displaced dorsally
Management
- Consult ortho in the ED; likely requires ORIF
- Long arm posterior splint with elbow flexed 90° and forearm pronated
- Linked image indicates neutral position of forearm, rather than pronation
- Pediatrics:
- Can manage with closed reduction if DRUJ stable after splinting
Disposition
- If splinted and stabilized, can be discharged after consultation with Ortho
- Will need close follow-up for likely operative repair
- Admit for:
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome
See Also
References
- ↑ Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33