Irreducible Galeazzi Fracture-Dislocations

Abstract

In the presence of a Galeazzi fracture, a reduced/stable DRUJ needs to be critically assessed as more than half of irreducible DRUJs in a Galeazzi fracture-dislocation were missed either pre- or intraoperatively.

Reconstructing a chronic, malunited Galeazzi fracture with distal radial ulnar joint instability: a simple, modified technique

“…The current standard of treatment of acute Galeazzi fractures is open reduction and internal fixation of the radius and DRUJ 9–12. Typically, osteosynthesis of the radial fracture is achieved with rigid plate fixation using a 3.5 mm or 4.5 mm dynamic compression plate.…”

A Case of Bilateral Galeazzi Fracture-Dislocations

“…In general, fracture shortening >5 mm, location of the fracture at the distal radial third (7.5 or 10 cm from the joint), widening of the DRUJs on posteroanterior view, displacement of the ulnar relative to the radius on the lateral view, and fracture of the ulnar styloid base, have been proposed as preoperative indicators of DRUJ instability [ 3 , 5 , 6 ]. Korompilias AV et al [ 4 ] proposed a three-type classification system based on the retrospective evaluation of 95 patients with Galeazzi fractures: Type I was located at the distal third (69 patients), Type II in the middle third (17 patients), and Type III at the proximal third (nine patients).…”

“…In rare instances, the DRUJ joint remains irreducible after fixation of the radial shaft fracture. Yohe NJ et al in 2019 [ 6 ] systematically reviewed the literature and found 17 cases among 12 studies; in dorsally unreduced DRUJs, a block to reduction in most cases (92.3%) was secondary to entrapment of one or more of the extensor tendons, with the remaining cases blocked by fracture fragments. Irreducible volar dislocations due to entrapment of the ulnar head occurred in 17.6% of cases with no tendon entrapment noted.…”

“…Type I fractures, located at the distal third of the radius shaft [ 4 ] or more specifically within 7.5 cm from its articular surface [ 5 ], demonstrate a higher incidence of DRUJ instability, requiring DRUJ stabilization in 53% [ 4 ] to 55% [ 5 ] of the patients. This fracture has been well known for its consequences to DRUJ stability and has been named “fracture of necessity” to clarify with early operative treatment, in terms of radial shaft fracture fixation that can reduce the dislocated ulna head without any other intervention; in cases of an unstable DRUJ, as judged intraoperatively, transfixation pinning, fixation of the ulna styloid fracture or rarely, open reduction of the joint are required [ 6 ]. Bilateral Galeazzi fracture-dislocations are extremely rare and only a few case reports have been described in the literature [ 7 - 10 ].…”

Perioperative management of distal radius fractures

“…Finally, Galeazzi fracture dislocation is a fracture of the distal third of the radius with an associated DRUJ dislocation ( Caldwell et al 2019 ). A Galeazzi fracture is typically due to a fall onto an outstretched hand (FOOSH) with the forearm in pronation ( Yohe et al 2019 ).…”