Galeazzi fracture-dislocation: Difference between revisions
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*Inspect skin for signs of open fracture | *Inspect skin for signs of open fracture | ||
*Assess distal pulses, motor, and sensation | *Assess distal pulses, motor, and sensation | ||
*Imaging: Plain radiographs | *Imaging: Plain radiographs<ref>Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33</ref> | ||
**PA: May only show slightly increased distal radioulnar joint space | **PA: May only show slightly increased distal radioulnar joint space | ||
**Lateral: Ulna is displaced dorsally | **Lateral: Ulna is displaced dorsally | ||
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==Disposition== | ==Disposition== | ||
*If splinted and stabilized, can be discharged after consultation with Ortho | *If splinted and stabilized, can be discharged after consultation with Ortho<ref>Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33</ref> | ||
**Will need close follow-up for likely operative repair | **Will need close follow-up for likely operative repair | ||
===Admit for=== | ===Admit for<ref>Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33</ref>=== | ||
*[[Open fracture]] | *[[Open fracture]] | ||
*Signs of neurovascular injury | *Signs of neurovascular injury | ||
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==See Also== | ==See Also== | ||
*[[Forearm Fracture]] | *[[Forearm Fracture]] | ||
==External Links== | |||
*http://radiopaedia.org/articles/galeazzi-fracture-dislocation | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
Latest revision as of 18:12, 17 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[1]
- 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[2]
- Will need close follow-up for likely operative repair
Admit for[3]
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome