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 Fractures

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
Galeazzi Fracture

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]

See Also

External Links

References

  1. Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33
  2. Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33
  3. Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33