Open reduction and internal fixation using plate and screws is the preferred treatment. In adults, the treatment of choice is surgical as the fractures do not yield good results with closed reduction and plaster cast application. Radiographs of the contralateral extremity can be obtained for comparison. In addition to stating the presence of the radial fracture and distal radio-ulnar joint dislocation, a number of features should be sought and commented on: Sometimes, the assessment of the distal radioulnar joint is difficult with plain radiography alone.īilateral axial computed tomography of the forearm is the preferred study for analyzing distal radioulnar joint injury. If greater than 10 mm, suggests complete disruption of the interosseous membrane.Radius shortening by more than 5 mm relative to the distal ulna.A comparison with the opposite wrist would help.Widening of the distal radioulnar joint on AP view.If the frank dislocation is not present, the following signs can indicate an injury to the distal radioulnar joint. There would be a dislocation of the distal radioulnar joint which is most notable on the lateral view. Radial shaft fracture is commonly seen commonly at the junction of the middle and distal third. Xray of -Fracture Shaft of Radius with Fracture of Ulnar styloid with Distal Radioulnar Joint Disruption fracture of Radius With Distal Radioulnar joint dislocation – Galeazzi Fracture DislocationĪnteroposterior and lateral view of forearm including elbow and wrist joint are sufficient to evaluate the injury. The xrays help to determine the level of the fracture, configuration of the fracture and associated distal radioulnar joint injury. This nerve affects the function of the flexor pollicis longus and flexor digitorum profundus to the index finger. The distal neurovascular examination should be done.Īnterior interosseous nerve, a division of the median nerve, can be injured with Galeazzi fracture. The function of the elbow joint should be assessed. Pain and soft-tissue swelling are present at the distal-third radial fracture site and at the wrist joint. There is a complaint of swelling in the distal third of the radius and wrist joint. This classification is based on the position of the radius after injury Walsh classification of Galeazzi Fracture The deforming forces in a Galeazzi fracture include But till now, the injury could not be reproduced in the lab so the exact forces are yet to be worked out.ĭirect blows on the dorsolateral side are also known mechanism of Galeazzi fracture injury. Rotation is often pronation but supination is also known to be associated. The conventional mechanism of injury is thought to be axial loading of the forearm along with rotation. The distal radioulnar joint is most stable in supination The joint is mainly stabilized by volar and dorsal radioulnar ligaments which function as the primary stabilizers of the DRUJ. Proximally, radial head articulates with the capitellum of the humerus to form radiocapitellar joint rotating within the annular ligament during pronation and supination.ĭistal radioulnar joint is formed between the sigmoid notch found along ulnar border of distal radius and the ulnar head. The ulnar head, distally, serves as an insertion point for the TFCC and supplements distal radioulnar joint. Three main stabilizers of this frame are triangular fibrocartilage distally, interoseous membrane which connects both the bone, and annular ligament which holds the proximal radius. The radius and ulna bones form the bony framework of the forearm. When the radial fracture is more than 7.5 cm from the articular surface, this incidence is 6%.įractures in the proximal two-thirds of the radius are not associated with injury to the distal radioulnar joint. The incidence instability of radial fracture is 55% when the fracture is within 7.5 cm from the articular surface. It is named after surgeon, Riccardo Galeazzi, who described this fracture in 1934 though Cooper was first to describe this injury pattern in 1842. Typically, Galeazzi fracture-dislocations occur due to a fall on an outstretched hand (FOOSH) with the elbow in flexion leading to axial loading on the hyperpronated forearm Most of these fractures are seen in children, with a peak incidence at age 9-12 years.Īdult Galeazzi fractures account for less than 7 percent of forearm fractures. The ulnar shaft is intact.Ī fracture of distal radius Galeazzi-equivalent fracture is a distal radial fracture with a distal ulnar physeal fracture 2. Galeazzi fracture-dislocations is a fracture of the distal third of the radius with dislocation of the distal radioulnar joint. Walsh classification of Galeazzi Fracture.Relevant Anatomy and Mechanism of Injury.
0 Comments
Leave a Reply. |