2/14/2024 0 Comments Type ii galeazzi fractureAfter the operation, the limb was rested in a long arm cast with the elbow in 90° of flexion and the forearm in a mid-prone position. His elbow had been asymptomatic before the operation and so was not formally tested for instability. His elbow range of movement was checked immediately after fixation, and radiographs confirmed the elbow to be in joint. Our patient underwent open reduction and anatomic fixation of the distal radius fracture with a compression plate via a standard volar Henry approach. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation. This can lead to instability of the elbow joint. ConclusionsĪlthough the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. Our patient was noted to have full elbow and forearm function at three months. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Post-operative radiographs films were satisfactory. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Case presentationĪ 26-year-old Caucasian man presented to our department after a fall from a motorbike. To the best of our knowledge, this has not been previously reported in the English literature. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions) or both. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. 2008).The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. As children approach skeletal maturity, the chance for failure of nonoperative treatment approaches that of adults (up to 92 %) and operative treatment should be strongly considered in any patient with closed physes (Eberl et al. Though successful treatment with immobilization in both long- and short-arm casts has been reported, inferior results have been reported with short-arm compared to long-arm casting in a case series of pediatric Galeazzi fractures (Walsh et al. The indications and contraindications to nonoperative management are illustrated in Table 3. However, the moniker of “fracture of necessity” still applies, in that, in order to treat this fracture nonoperatively, an anatomic reduction is necessary, as is weekly radiographic follow-up to ensure appropriate alignment is maintained. Unlike adults, where Galeazzi fractures have been termed the fracture of necessity (necessitating operative fixation), the majority of Galeazzi fractures in children can be successfully treated nonoperatively.
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