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Home | LITFL | Eponymictionary | Galeazzi fracture

Galeazzi fracture
by Dr Dean Fulford and Dr Mike Cadogan, last update September 14, 2019

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Description

Fracture of the distal third of the radius with associated distal radio-ulna joint (DRUJ)
disruption.

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History
1822 – Fracture pattern actually first described by Sir Astley Cooper some 110 years prior to Galeazzi’s
publication. Copper describes cases of radius fracture with DRUJ disruption and ulna dislocation [pp473–
476] [Plate XXVIII Fig 1,2] [Image]

Astley Cooper description 1822

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1912 – William Darrach (1876–1948) reported a 20 year old male presenting with an 8 week old injury
with ‘fracture of the radial shaft 2.5 inches above the lower margin with anterior bowing and a forward
dislocation of the head of ulna‘. He attempted closed reduction unsuccessfully prior to open reduction and
splinting in pronation. Reviewed 18 months later, found patient unable to pronate/supinate –
recommended subperiosteal excision of the distal end of the ulna for delayed cases of ulnar head
dislocation (Darrach procedure) [1912; 56(5):801–803]

1922 – Homans and Smith attempted open reduction of the radius fracture and applied a splint, but found
a tendency for angulation and delayed union in cases associated with a dislocation of the radioulnar joint.
[1922; 187(11):401–406]

1925 – Further attempts at open reduction by Wilson and Cochrane (1925) and Milch (1926) with
triangular fibrocartilage repair with a fascial graft – with poor outcomes

1934 – Riccardo Galeazzi described radial shaft fracture with associated DRUJ dislocation and published
his experience of 18 cases. He reduced the radial shaft fracture by pulling on the thumb with the forearm
in the supinated position, and the ulnar head by radially deviating the wrist, and maintained the reduction
using a plaster of Paris cast.

Associated Persons
Riccardo Galeazzi (1866 – 1952)
Sir Astley Paston Cooper (1768 – 1841)
Giovanni Battista Montéggia (1762 – 1815)

Alternative names
Galeazzi fracture-dislocation
Reverse Monteggia fracture
Piedmont fracture
Darrach Hughston-Milch fracture

Controversies
Fracture pattern actually first described by Sir Astley Cooper in 1822 and published in 1824 some 110
years prior to Galeazzi’s publication.

References

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Cooper A. A treatise on dislocations, and on fractures of the joints. London: Longman; 1824. [pp473–
476] [Plate XXVIII Fig 1,2]
Darrach W. Forward dislocation at the inferior radio-ulnar joint with fractures of the lower third of the
radius. Annals of Surgery. 1912; 56(5):801–803.
Lau FH, Chung KC. William Darrach, MD: his life and his contribution to hand surgery. J Hand Surg
Am. 2006 Sep;31(7):1056-60. [PMID 16945703]
Homans J, Smith J. Fracture of the lower end of the radius associated with fracture or dislocation of
the lower end of the ulna. Boston Med Surg J 1922; 187(11):401–406.
Galeazzi R. Uber ein besonderes Syndrom bei Verletzungen im Bereich der Unterarmknochen. Archiv
fur orthopadische und Unfall Chirurgie 1934; 35:557–562. [Galeazzi fracture]
Galeazzi R. Di una particolare sindrome traumatica dello scheletro dell’ avambraccio. Atti e memorie
della Società lombarda di chirurgia. (Of a particular traumatic syndrome of the forearm’s skeleton).
1934;2:663–666
Sebastin SJ, Chung KC. A Historical Report on Riccardo Galeazzi and the Management of Galeazzi
Fractures. J Hand Surg Am. 2010 Nov;35(11):1870-7 [PMC4411960]
Scaglietti O. Riccardo Galeazzi, 1866-1952. Journal of Bone and Joint Surgery (British). 1953;35-
B:679-80

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Dr Dean Fulford
Dr Dean Fulford, reformed orthopaedic surgeon now Anaesthetics trainee.

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