Galeazzi fracture-dislocation
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
- 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
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