Galeazzi fracture-dislocation
Revision as of 18:12, 17 March 2018 by Rossdonaldson1 (talk | contribs)
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