p.292-346.įeedback Content developed by Victorian Paediatric Orthopaedic Network.Most recent articles on Galeazzi fractureĪrticles on Galeazzi fracture in N Eng J Med, Lancet, BMJĬochrane Collaboration on Galeazzi fracture Lippincott Williams & Wilkins, Philadelphia 2010. In Rockwood and Wilkins' Fractures in Children, 7 th Ed. Fractures of the distal radius and ulna: Metaphyseal and physeal injuries. References (ED setting)Ītesok KI, Jupiter JB, Weiss AP. This usually resolves with observation.įracture clinics for other potential complications. Nerve injury is uncommon, but cases have been reported with injuries to the ulnar nerve. What are the potential complications associated with this injury?ĭelayed diagnosis is a frequent complication. Poor outcomes are usually a result of a delayed diagnosis or if the forearm has been immobilised in an incorrect position or in a below-elbow cast. The majority of these fractures will do well. This should be arranged by the consulting orthopedic team after their reduction and stabilisation of the injury.
What follow-up is required?įollow-up in fracture clinic needs to be in 7 days with an x-ray. The arm should be splinted and the nearest orthopaedic on call service consulted. What is the usual ED management for this fracture? Other indications for prompt consultation include:ĩ. Do I need to refer to orthopaedics now?Īll Galeazzi fracture-dislocations should be referred to the nearest orthopaedic on call service. Fluoroscopy should be used to assess stability of the DRUJ after reduction.Īdolescents are more likely to need open or percutaneous fixation to stabilise the DRUJ after reduction. When is reduction (non-operative and operative) required?įor children, most of these fractures can be managed with closed reduction. If there is an isolated radius fracture, always examine the DRUJ on x-ray.įigure 2: 14 year old boy with Galeazzi fracture-dislocation. These fractures are often missed and may be difficult to recognise. What radiological investigations should be ordered?Īnteroposterior (AP) and lateral x-ray of the forearm, which includes the wrist and elbow, should be obtained. Deformity through the forearm is usually clinically evident. The forearm and wrist will be painful to move. There will be swelling at the distal forearm and/or wrist. More common is the Galeazzi equivalent, where there is a distal radius fracture with a distal ulna physeal fracture but without disruption of the DRUJ (Figure 1).įigure 1: A Galeazzi equivalent injury is characterised by fracture of the radius with fracture through the distal growth plate of the ulna but without disruption of the DRUJ. The most common mechanism is a fall on an outstretched hand with forearm rotation. These injuries are very rare in children. How common are they and how do they occur? They can be classified by the direction of the ulna displacement:ģ. How are they classified?Ī Galeazzi fracture-dislocation is a fracture of the distal third of the shaft of the radius with a disruption to the DRUJ. If there is an isolated radius fracture, always examine the distal radioulnar joint (DRUJ) on x-ray.įor all Galeazi fracture-dislocations, the arm should be splinted and the nearest orthopaedic on call service should be consulted. Galeazzi fracture-dislocations are often missed and may be difficult to recognise. What are the potential complications associated with this injury?.What is the usual ED management for this fracture?.Do I need to refer to orthopaedics now?.When is reduction (non-operative and operative) required?.What radiological investigations should be ordered?.How common are they and how do they occur?.Galeazzi fracture-dislocation - Fracture clinics
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