MANUAL MINORS
A Galeazzi fracture-dislocation is a complex forearm injury involving a fracture of the distal third of the radius combined with a dislocation of the distal radioulnar joint (DRUJ). This type of injury typically results from high-energy trauma, such as falls onto an outstretched hand or car accidents. Patients experience severe pain, swelling in the forearm and wrist, and often visible deformity. It is an unstable injury and requires urgent treatment.
Diagnosis
Diagnosis is made through a physical examination, which reveals pain, swelling, and often palpable prominence or instability at the wrist (distal radioulnar joint). X-rays of the forearm are essential to confirm the radius fracture and DRUJ dislocation. In some cases, a CT scan may be requested to better plan surgical treatment.
Differential Diagnosis
Condition | Distinctive Characteristics |
|---|---|
Monteggia fracture | Ulna fracture with dislocation of the radial head, affecting the elbow rather than the wrist. |
Isolated distal radius fracture | Affects only the radius without dislocation of the DRUJ. |
Fracture of both forearm bones | Fractures of both the radius and ulna without DRUJ dislocation. |
Wrist sprain | Pain without visible fractures or dislocations on X-rays. |
Emergency Management
Emergency management includes immediate immobilisation of the forearm with a splint or cast to prevent further damage. Analgesics should be given to control pain. If the DRUJ dislocation compromises blood flow or nerves, urgent reduction is required. However, in most cases, definitive surgical reduction is planned.
Definitive Treatment
Definitive treatment is typically surgical. An open reduction of the radius fracture is performed, stabilising it with plates and screws. The dislocation of the distal radioulnar joint is usually reduced through a closed procedure once the radius is stabilised. After surgery, the forearm is temporarily immobilised, followed by physiotherapy to restore function and mobility of the forearm and wrist.
Commentaires