Presentation
Motorcycle accident. Obvious wrist deformity upon inspection.
Patient Data
Forearm radiographs revealed a distal radial fracture associated with a dislocation of the distal radioulnar joint, in keeping with a Galeazzi fracture-dislocation.
Furthermore, there is an associated midshaft fracture of the ulna.
Radiographs performed immediately post-op. The patient underwent open reduction and internal fixation with plating of the radius and ulna. The distal radioulnar joint was unstable and transfixed with a K-wire.
Case Discussion
Galeazzi fracture-dislocations are described as distal half radial fractures associated with a disruption of the distal radioulnar joint (DRUJ).
Unlike isolated radial fractures, a Galeazzi fracture in an adult demands operative management.
In the present case, the DRUJ is clearly dislocated, but sometimes the injury may be more subtle. Some radiographic findings suggestive of a DRUJ injury are:
- ulnar styloid base fracture
- widening of the DRUJ
- dislocation/subluxation of the radius relative to the ulna on the lateral view
- shortening of the radius >5 mm
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