Galeazzi Fractures



Galeazzi Fractures


Maharsh K. Patel

Joseph J. King



INTRODUCTION



  • Pathoanatomy



    • Galeazzi fractures are defined as a fracture of the distal one-third radial shaft and associated distal radioulnar joint (DRUJ) injury.



      • Variants—fractures anywhere along the radius or fractures of both the radius and ulna with DRUJ disruption


    • DRUJ is the distal articulation of the ulna within the sigmoid notch on the ulnar border of the distal radius.



      • Primarily stabilized by triangular fibrocartilage complex (TFCC)



        • Also has volar and dorsal distal radioulnar ligaments


      • DRUJ is most stable in supination.


    • Incidence of DRUJ instability



      • Unstable in 55% when radius fracture is <7.5 cm from articular surface


      • Unstable in 6% when radius fracture is >7.5 cm from articular surface


    • Major deforming forces



      • Pronator quadratus—insertion pronates the distal radius with proximal and volar displacement


      • Brachioradialis—causes shortening


      • Thumb extensors and abductors—result in shortening and relaxation of the radial collateral ligament


  • Mechanism of injury



    • Indirect trauma such as a fall onto an outstretched hand with the forearm in pronation (Figure 30.1)



      • Forceful axial loading with torsion of forearm


    • Direct trauma to the forearm and/or wrist



      • Motor vehicle accidents, blunt trauma, etc.



  • Epidemiology



    • Incidence



      • ≤3% of all forearm fractures in children


      • ≤7% of all forearm fractures in adults






FIGURE 30.1 Mechanism of injury. A, a type I fracture (apex volar) that occurs with axial loading with the forearm in supination. B, a type II fracture (apex dorsal) that occurs with axial loading with the forearm in pronation. From atesok KI, Jupiter JB, Weiss APC. Galeazzi fracture. J Am Acad Orthop Surg. 2011;19(10):623-633.


EVALUATION

May 7, 2019 | Posted by in ORTHOPEDIC | Comments Off on Galeazzi Fractures
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