Irreducible Galeazzi Fracture-Dislocations
Nicholas J Yohe1, Jadie De Tolla1, Marc B Kaye1
11 Maimonides Medical Center, Brooklyn, NY, USA.
Hand (New York, N.Y.)
|November 30, 2017
Summary
Galeazzi fractures with distal radioulnar joint disruption require careful assessment. Over half of irreducible joint dislocations are missed, often due to tendon entrapment, necessitating critical evaluation for proper management.
Area of Science:
- Orthopedic surgery
- Traumatology
- Upper extremity injuries
Background:
- Galeazzi fractures involve radial shaft fractures with distal radioulnar joint (DRUJ) disruption.
- Treatment typically involves radius reduction and DRUJ stability assessment.
- Rarely, interposed structures block DRUJ reduction, requiring open joint reduction.
Purpose of the Study:
- To review all reported cases of irreducible Galeazzi fracture-dislocations.
- To establish diagnostic and management guidelines for this rare injury.
Main Methods:
- Literature search of MEDLINE, OVID, and PubMed databases.
- Keywords used: "Galeazzi" and "fracture."
- Analysis of 17 cases from 12 articles.
Main Results:
- All cases involved high-energy mechanisms, with patients aged 16-64 years (mean 25).
- Over half of irreducible DRUJ dislocations were missed pre- or intraoperatively.
- Dorsal dislocations commonly involved extensor tendon entrapment (92.3%); volar dislocations involved ulnar head entrapment (17.6%).
Conclusions:
- Critical assessment of DRUJ stability is essential in Galeazzi fractures.
- Missed irreducible DRUJ dislocations are common, highlighting diagnostic challenges.
- Early identification and management are crucial for favorable outcomes.
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