Galeazzi

Fracture-
dislocation
Dr jaffar alsayigh
Dr Abdullah alshehri
Orthopedic Department - KFHU
Outlines:
• Introduction
• Anatomy of the forearm and associated clinical anatomy
• Classifications of Galeazzi fracture
• Clinical presentation
• Imaging
• Treatment
• Complications
Introduction
• fracture of the distal thirds of the radius with disruption of the DRUJ
• Incidence of DRUJ instability
radial fracture is <7.5 cm from articular surface (unstable in 55% of the
cases)
radial fracture is >7.5 cm from articular surface (unstable in 6% of the
cases)
 Anatomy
• Arthrology
Articulation occurs between the ulnar head
and sigmoid notch (a shallow concavity
found along ulnar border of distal radius)
The triangular fibrocartilage
complex (TFCC)
• load-bearing structure between the lunate, triquetrum, and ulnar head.
• act as a stabilizer for the ulnar aspect of the wrist.

• Components:
vtriangular fibrocartilagous articular disc
v volar and dorsal radioulnar ligaments (main stabilizer)
vvolar ulnotriquetral and ulnolunate ligaments,
vulnar collateral ligament
vextensor carpi ulnaris (ECU) tendon sheath
vulnomeniscal homologue
Radial bow and length
OTA Classification
OTA Classification
Macule Beneyto Classification

• Type 1: 0-10cm from styloid process (61%)

• Type 2: 10-15cm from styloid process (30%)

• Type 3: more than 15cm from styloid process (9%)

 Mechanism
vdirect wrist trauma
typically, dorsolateral aspect
vFOOSH with forearm in pronation
Presentation
• Symptoms
• Pain, swelling, deformity

• Physical exam
• Look, feel, move
• ROM
Test forearm supination and pronation for instability
• DRUJ stress
Causes wrist or midline forearm pain
• DNV and compartment
Imaging
AP and lateral for elbow, forearm and wrist

vsigns of DRUJ injury:

• ulnar styloid fracture
• widening of DRUJ
• dorsal or volar displacement
• Radial height shortening
Treatment
• Operative:
• ORIF of radius with reduction and stabilization of DRUJ

• indications
• all cases, as anatomic reduction of DRUJ is required
ORIF of Radius Fracture.
• Volar Approach (Henry)
• Anatomic fixation (absolute
reduction)
• Restore radial bow and length.

• Check DRUJ stability.

DRUJ
• If DRUJ is stable: above elbow splint in supination for 4-6 weeks with
mobilization after 2 weeks.
• If DRUJ is reducible but it’s unstable: ulna to radius percutaneous pin
fixation.
• If DRUJ irreducible: means, there is soft tissue blocking, need to open
and reduce and then stabilize (dorsal capsulotomy)
• If there is an ulnar styloid fracture: ORIF with K-wires or screw, then
check for stability
Rehabilitation
• If DRUJ is stable post Distal radius fixation start active ROM after 10-
14 days.
• If DRUJ is unstable and treated with splinting or k-wire, active ROM to
be started after removal of splint/k-wire. (4-6 weeks).
Complications
• Compartment syndrome.
• Neurovascular injury.
• Refracture.
• Nonunion
• Malunion
• DRUJ subluxation