Galeazzi Fracture Research Articles

Arthroscopy for Galeazzi fractures, a way to demonstrate TFCC damage in extra-articular radius fracture: A series of 7 cases

Galeazzi fracture is a trauma associating diaphysal radius fracture and dislocation or subluxation of the distal radio-ulnar joint (DRUJ). Despite an anatomic reduction of the radius, DRUJ impairment, especially injury of triangular fibrocartilage complex (TFCC) may lead to partial instability with secondary pain and stiffness. This prospective case series proposes to perform wrist arthroscopy for Galeazzi fractures in order to diagnose ligamentous injuries and to enable their reparations. Over a period of 18 months, 7 recent Galeazzi closed fractures were operated on with wrist arthroscopy. We used a locking compression plate, a 1.9 mm arthroscope with 3 radio-carpal portals: 3-4, 4-5 and 6U. A dorsal forearm splint was kept for 3 weeks followed by an active/passive physiotherapy. Physical examination and X-ray were performed after 3, 6 and 12 weeks. Analysis criteria were: – perioperative: ligament impairment, duration of surgery; – postoperative: pain, wrist motion (flexion/extension; prono/suppination), grasp strength, time off work and sports, X-ray analysis (reduction, consolidation, secondary displacement). All patients were reviewed 3 times. The triangular ligament was injured in all cases, 3 cases in the radial part, 3 cases in the ulnar part and one both side. All ulnar injuries were repaired systematically. The radial TFCC injuries were only repaired when DRUJ instability persisted despite good reduction of the radius. After osteosynthesis of the radius, DRUJ remained instable in 3 cases, one ulnar lesion, one radial and one both side. The reparation of the triangular ligament improved stability of the DRUJ in 2 cases, one case remained instable despite TFCC reparation. About strength and mobility: – after 3 weeks: F/E: 50/60°, P/S 45°/45°, grasp 20%; – after 6 weeks: F/E: 80/80°, P/S 70°/60°, grasp 45%; – after 12 weeks: F/E: 85/80°, P/S 80°/75°, grasp 80%. We noticed 7 anatomic radius reductions and no secondary displacement. A dorsal DRUJ subluxation was noticed despite the ulnar TFCC repair; none nonunion was reported. Time off work was 7 weeks (4–10). Functional mobility was regained after 6 weeks, accompanied by good strength. TFCC reparation participate in DRUJ stabilization but was not always sufficient to fully stabilize the DRUJ. A next study with DRUJ MRI and prono-supination strength measurement should participate to demonstrate further benefits of TFCC reparation in Galeazzi fractures. A lesion of the TFCC was noticed in all cases suggesting that TFCC lesion could occur in some other extra-articular distal radius fractures.

Wrist arthroscopy in extra-articular distal radius fractures: Extra-articular fractures are articular trauma, a prospective series of 35 cases

Introduction In articular distal radius fractures, arthroscopy has demonstrated benefits to diagnose and treat ligament injuries of the wrist, in particular for the triangular fibrocartilage complex (TFCC). For extra-articular radius fractures, this prospective series proposes to assess ligament injuries (especially TFCC) with a systematic wrist arthroscopy. Indeed, the two forearm bones work as a functional unit and the fracture of one bone often induces a fracture of the second one. When the fracture of the second bone does not occur, we can suspect a dissociative ligamentous injury between the 2 bones, especially a TFCC injury. This hypothesis was oriented by our recent series concerning TFCC injuries in Galeazzi fractures. Materials and methods Over a period of one year, 35 extra-articular distal radius fractures were operated on with systematic radiocarpal arthroscopy. Selected patients were younger than 65 years with recent closed surgical extra-articular radius fractures associated or not with an ulnar fracture. We used a locking anatomical compression plate, a 1.9 mm arthroscope with 3 systematic radio-carpal portals: volar radiocarpal, 3-4, 4-5 and an extra 6U portal for TFCC repair. A splint was kept for 3 weeks followed by an active/passive physiotherapy. Physical examination and X-ray were performed after 3, 6 and 12 weeks. Analysis criteria were: – perioperative: ligament injuries, duration of surgery; – postoperative: pain, wrist motion (F/E°; P/S°), grasp strength, time off work and sports, X-ray analysis (reduction, consolidation, secondary displacement). Results Five patients were only reviewed twice. The TFCC was injured in 21 cases: – with ulnar fractures (n = 20): 8 injuries including 6 radial lesions; – without ulnar fracture (n = 15): 13 injuries including 9 ulnar lesions. One radial TFCC injury and all ulnar lesions were repaired. About strength and motion: – after 3 weeks: F/E: 60/55°, P/S 60°/70°, grasp 23%; – after 6 weeks: F/E: 75/70°, P/S 75°/80°, grasp 52%; – after 12 weeks: F/E: 85/80°, P/S 80°/80°, grasp 88%. We noticed 30 anatomic reductions and none secondary displacement. Time off work was 4 weeks (0–7). Discussion and conclusion Extra-articular radius fractures without ulnar fracture were often associated with TFCC injuries, rather ulnar. Both bone fractures were less associated with TFCC injuries, rather radial. This study is a first step demonstrating a diagnosis interest in systematic wrist arthroscopy for extra-articular radius fractures. In order to demonstrate a prognosis interest in rapidity and quality of recovery, a further comparative study with prono-supination strength and power measurement should be necessary.

Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation.

Late rupture of extensor pollicis longus (EPL) tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP). He was managed with extensor indicis proprius (EIP) transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

Galeazzi Fractures: our Modified Classification and Treatment Regimen

While diaphyseal fractures of the forearm are a common orthopedic injury, Galeazzi fractures are difficult to treat. The current knowledge on pathobiomechanics and modified therapeutic decisions implicate the need to devise an updated classification and treatment regimen of Galeazzi fractures. We challenge the concept that isolated fractures of the radius should be considered as a Galeazzi fractures as long as stability of the distal radioulnar joint is not proven. Contrary to others we demonstrate that the fracture location alone is not sufficient to determine the stability of the distal radioulnar joint.

Early rehabilitation in unstable bilateral Galeazzi fracture dislocation: Role of transfixing K wires

The Galeazzi fracture is a fracture of the middle to distal third of the radius associated with dislocation and/or instability of the distal radioulnar joint (DRUJ). Operative treatment followed by conventional immobilization of 6-8 weeks is usually followed by good outcome, but it takes nearly 1 year for occupational rehabilitation and most cases are associated with restricted terminal range of motion. To avoid these consequences, early commencement of rehabilitation is necessary but for that the DRUJ must be stable after radial fixation. Here, we report a case of early rehabilitation in a 36-years-old horse trainer with bilateral Galeazzi fracture dislocation where both DRUJ were unstable after fixation of radius but transfixing K wires provided the required stability needed for early mobilization. The patient had complete range of motion and occupational rehabilitation by 4 months.

A Rare Case of Fracture of Radius Associated with Dislocation of Both Distal and Proximal Radio-Ulnar Joint

Single bone forearm fractures are usually associated with dislocation of one radio-ulnar joint. The association of ulnar fractures with dislocation of proximal radio-ulnar joint and radius fractures with distal radio-ulnar joint is well described. Classically they are better known as Monteggia and Galeazzi fracture dislocations respectively. These peculiar presentations are attributed to intricate relationship of the forearm bones joined together as a unit by two radio-ulnar joints at proximal and distal ends and the interosseous membrane in the middle part. However, simultaneous dislocation of the both radio-ulnar joints associated with fracture of single bone is a very rare event. Literature search does not reveal a single case of such type. We are presenting here a case of fracture shaft of radius associated with dislocation of both proximal and distal radio-ulnar joints. The patient was managed by open reduction and fixation of the radius by a compression plate and the dislocations were reduced by closed method and stabilized with small K wires.

Treatment of isolated diaphyseal fractures of the radius with an intramedullary nail in adults

The goal of the radius diaphysis fractures in surgical treatment is restoration of bone length, rotation correction and to secure fixation that allows early mobilization. The purpose of this study is evaluating the results of intramedullary (IM) radius nail for the treatment of isolated adult diaphyseal fractures of the radius. We retrospectively reviewed adults with isolated fractures of the radius, who were treated with closed or mini open reduction with a IM radius nail between May 2008 and November 2011 and who were followed for a least 1 year. Patients with a Galeazzi fracture, a pathological fracture, or patients with nonunion after previous surgeries were excluded. All patients were allowed full range of motion without any external support. Primary outcomes were Grace and Eversmann rating, Disabilities of the Arm, Shoulder and Hand (DASH) scores. Twenty-three enrolled patients (mean age 34 years; 17 men) had 23 isolated radius fractures. Mean time to fracture union was 12 weeks (range 10-13 weeks) for radius fractures. No patient had nonunion, deep infections, or radioulnar synostosis. Follow-up ranged from 12 to 42 months. Grace and Eversmann ratings of 21 patients were excellent or good, and 2 patients were medium. Mean DASH score was 4.2 points (range 0-13.3). Our experience indicates that this new IM radius nail may be considered as an alternative to plate osteosynthesis for fractures of the radius diaphysis in adults. IM nailing of radius fractures provides reliable bony union and excellent postoperative clinical results in adults.

The effect of a Galeazzi fracture on the strength of pronation and supination two years after surgical treatment

The aim of this study was to determine the effect of a Galeazzi fracture on the strength of pronation and supination at a mean of two years after surgical treatment. The strength of pronation and supination was measured in varying rotational positions of the forearm of ten male patients (mean age 38.9 years (21 to 64)) who had undergone plate fixation for a Galeazzi fracture. The stability of the distal radioulnar joint was assessed, and a clinical assessment using the quick-Disabilities of the Arm Shoulder and Hand (quickDASH) questionnaire and patient-related wrist examination (PRWE) scores was undertaken. In addition, the strength of pronation and supination was measured in a male control group of 42 healthy volunteers (mean age 21.8 years (18 to 37)). The mean absolute loss of strength of supination in the injured compared with the non-injured arm throughout all ranges of forearm rotation was 16.1 kg (sem 5.3), corresponding to a relative loss of 12.5% (95% confidence interval (CI) 3.6 to 21.4). For the strength of pronation, the mean loss was 19.1 kg (sem 4.5), corresponding to a relative loss of 27.2% (95% CI 14.2 to 40.1). Loss of strength of supination following a Galeazzi fracture correlated with poor quickDASH (p = 0.03) and PRWE scores (p < 0.01). Loss of strength of pronation (27.2%), and of supination (12.5%) in particular, after a Galeazzi fracture is associated with worse clinical scores, highlighting the importance of supination of the forearm in function of the upper limb.

New interlocking intramedullary radius and ulna nails for treating forearm diaphyseal fractures in adults: A retrospective study

IntroductionThe treatment goal for diaphyseal forearm fractures in adults is to restore axial and rotational stability. The treatment of these fractures with intrmaedullary locked nailing remains sparse. We therefore evaluated IM nails for treating forearm diaphyseal fractures in adults. MethodsWe retrospectively reviewed adult patients with isolated unilateral or bilateral fractures of the radius, ulna, or both, who were treated with closed or mini open reduction with a new IM nail between May 2008 and January 2012 and who were followed for a least 1 year. Patients with a Galeazzi fracture, a pathological fracture or patients with nonunion after previous surgeries were excluded. All patients were allowed full range of motion without any external support. Primary outcomes were Grace and Eversmann rating, Disabilities of the Arm, Shoulder and Hand (DASH) scores. ResultsThe 43 enrolled patients (mean age, 37 years; 32 men) had 59 forearm fractures: 14 isolated radius fractures, 17 isolated ulna fractures (2 bilateral), and 28 fractures of both the radius and ulna. Mean time to fracture union was 13 weeks (range 10–14 weeks) for ulnar fractures and 12 weeks (range 10–13 weeks) for radial fractures. No patient had nonunion, deep infections, or radioulnar synostosis. Followup ranged from 12 to 44 months. Grace and Eversmann ratings were excellent in 38 patients and good in 5. Mean DASH score was 6.5 points (range 0–13.3). ConclusionsIntramedullary nailing of adult forearm diaphyseal fractures appears to be a good alternative to plate osteosynthesis. The advantages are short operative time, minimal invasive techniques, and sufficient stability in all planes that allows early motion without additional fracture support.

English

Abstract Introduction Double injury patterns in the form of Monteggia or Galeazzi fracture dislocation represent a spectrum of forearm injuries which are severe and usually necessitate operative intervention. Association of ulnar dislocation with proximal radioulnar disruption with fracture of the radial shaft, without dislocation of radiohumeral joint, represents a rare and unusual double injury pattern which is not classified under the Bado classification system. Although easy to identify, understanding the injury morphology ensures proper treatment. The aim of this study is to present an unusual case of Monteggia variant. Case Report A 26-year-old male presented following a road traffic accident with posterior dislocation of ulna and proximal radioulnar disruption with radial shaft fracture at the junction of proximal and middle third; radial head maintained its relation with capitellum. Valgus instability necessitating treatment could be demonstrated despite of posterolateral stability even after close reduction and fixation of radius. Conclusion This injury may be classified as an unusual variant of Monteggia fracture dislocation with emphasis on associated management of medial collateral ligament depending on the patient’s profile and fracture personality for optimal results. Introduction Double injury patterns in the form of Monteggia or Galeazzi fracture dislocation represent a spectrum of forearm injuries which are severe and usually necessitate an operative intervention. Because the forearm bones and the proximal and distal joints form a closed parallelogram, injury to one is usually accompanied by injury to the opposite limb of the parallelogram. The most common injury patterns are accompanied by either disruption of the distal radioulnar joint or radiocapitellar articulation. We report a case of ulnar dislocation with proximal radioulnar disruption and fracture of the radial shaft without dislocation of the radiohumeral joint. This double injury pattern has been infrequently reported. Although the pattern is easy to identify, understanding the injury morphology is necessary to ensure proper treatment.

T1.3 Treatment of pediatric unstable forearm fractures with intramedullary Kirschner wires

Introduction: The treatment goal for diaphyseal single and both bone fractures in adults is to restoration of bone length, provide axial and rotational stability, and to secure fixation that allows early mobilization. Intramedullary (iM) nails are not routinely used in the surgical treatment of forearm fractures. However, this trend has started to change with the newly designed interlocking iM nails. We evaluated a new iM nails for treating forearm diaphyseal fractures in adults. Materials and Methods: We retrospectively reviewed adults with single and both bone fractures, who were treated with a new iM radius and ulna nails between May 2008 and May 2011 and who were followed for a least 1 year. Patients with a Galeazzi fracture, a pathological fracture or patients with nonunion after previous surgeries were excluded. All patients were allowed full range of motion without any external support. The results were evaluated according to Grace–Eversmann and DASH scores. Results: The 61 enrolled patients (mean age, 37 years; 32 men) had 83 forearm fractures: 23 isolated radius fractures, 18 isolated ulna fractures (2 bilateral), and 40 fractures of both the radius and ulna. Mean time to fracture union was 13 weeks (range, 10 to 14 weeks) for ulnar fractures and 12 weeks (range, 10 to 13 weeks) for radial fractures. No patient had non-union, deep infections, or radioulnar synostosis. Followup ranged from12 to 38months. Grace–Eversmann ratingswere excellent in 53 patients, good in 5,medium in 2 and poor in 1. Mean DASH score was 6.5 points (range, 0 to 13.3). Conclusion: The new intramedullary nail systemsmay be considered as a good alternative to both classical intramedullary nails and plate osteosynthesis in adult forearm diaphyseal fractures. The advantages are short operative time, insertion by closed and minimal invasive techniques mostly, the use of a minimally scope, smaller operative scar and sufficient stability in all planes that allows early motion without additional support. T1.2 Acromioclavicular reconstruction using hook plate and anterior tibial tendon allograft with triple tunnel: can it be considered as an alternative surgical technique? A. Deveci1, A. Firat2, S. Yilmaz1, K.O. Unal1, H.I. Acar3, A.O. Yildirim1, M. Bozkurt4. 1Ankara Numune Education and Research Hospital, 2Ankara Kecioren Education and Research Hospital, 3Ankara University Department of Anatomy, 4Ankara Ataturk Education and Research Hospital, Ankara, Turkey

An unconventional indication of the Sauve' - Kapandji procedure in a radial shaft pseudoarthrosis and chronic DRUJ dislocation: a case report.

We present a 42-years-old male who developed a radial shaft pseudoartrosis and a chronic DRUJ dislocation/instability, following a Galeazzi fracture. He presented to our Office with a severe inability of wrist and forearm motion. A Sauve'-Kapandji procedure was adopted, performing a lateral approach to the ulna and grafting the excised ulnar block to retrieve radial length at the pseudoarthrosis level. Cancellous bone grafts from the iliac crest were also applied and mixed with autologous platelet rich plasma to promote callus formation. The goal was to create an intentional pseudoarthrosis of the distal ulna combined with a DRUJ arthrodesis, in order to resolve instability and regain forearm pronation/supination. We obtained bone healing, an excellent clinical recovery, and the patient returned to all his previous activities six months after surgery. To our knowledge, this is the first reported case of a radial shaft psudoarthrosis treated with the Sauve'-Kapandji technique.

Isolated volar dislocation of distal radioulnar joint: rarely occurring, commonly missed

IntroductionDistal radioulnar joint dislocations with associated fractures,such as Galeazzi fracture or distal radius fracture, are com-mon injuries. However, isolated dislocation of distal radio-ulnar joint without fracture is rare and is described in termsof the position of the ulna in relation to the radiocarpal joint[1]. Dorsal dislocation is more common than volar disloca-tion [2, 3]. Because of the paucity of this injury, emergencyphysician may easily miss this injury and the deformedwristmay present to the orthopedic surgeon later. Early diagnosis,reduction,andimmobilization restore forearm rotation inthemajority of cases. Failed closed reduction and unstableDRUJ, however, requires surgical stabilization.Case reportA 16-year-old male sustained an injury to his left wrist aftera fall on outstretched hand. He came to our A&E where anemergency physician attended him. His wrist was X-rayed,and considering no bony injuries, a differential of soft tissueinjury was made. A wrist splint was applied and he wasasked to consult an orthopedic surgeon. Two days later, hepresented to our out-patient department.On examination, there was moderate swelling of the wristand marked restriction of movement. Tenderness could beelicited over ulnar styloid and DRUJ region. Careful exam-ination of the previous X-ray was suggestive of minimallydisplaced ulnar styloid fracture in the anteroposterior viewand volar dislocation of DRUJ in the lateral view [Fig. 1].The dislocation was reduced under supraclavicular blockunder an image intensifier. Radioulnar transfixation with a1.8-mm K-wire was done, as the joint was unstable [Fig. 2].Limb was immobilized in an above elbow cast. The fractureof ulnar styloid was minimally displaced and just above thebase. It assumed itsposition after relocation ofulna so it wasnot fixed. The cast as well as the K-wire was removed after6 weeks [Fig. 3]. Gradual physiotherapy regained full func-tion and movements of wrist after 4 weeks. A 1-year follow-up reduced DRUJ, leading to pain-free wrist with full rangeof movements.DiscussionCotton and Brickley [4] were the first to describe this injurypattern in cadaver. Forced hypersupination of the forearmgenerally results in volar dislocation of the ulna. Other

Long-Term Outcome of Isolated Diaphyseal Radius Fractures With and Without Dislocation of the Distal Radioulnar Joint

We tested the hypothesis that there are no differences between apparently isolated fractures of the radial diaphysis and isolated fractures of the radial diaphysis with concomitant dislocation of the distal radioulnar joint (DRUJ) in function, disability, and DRUJ stability more than 13 years after near-anatomic open reduction with plate and screw fixation. We evaluated 17 adult patients with a diaphyseal fracture of the radius without a fracture of the ulna an average of 19 years after surgery (range, 13-33 y). Of these patients, 7 had concomitant dislocation of the DRUJ (Galeazzi fracture). At the long-term follow-up, we evaluated function with several composite scores, stability of the DRUJ, and arm-specific disability by using the Disabilities of Arm, Shoulder, and Hand questionnaire. The average scores were 96 (range, 85-100) on the Mayo Modified Wrist Score, 95 (range, 80-100) on the Mayo Elbow Performance Index, and 5 (range, 0-33) on the Disabilities of Arm, Shoulder, and Hand questionnaire. There were no significant differences between patients with and without DRUJ dislocation. No patients had greater laxity of the DRUJ than the opposite uninjured side. Near-anatomic open reduction and internal fixation of diaphyseal radius fractures with and without associated DRUJ dislocation have comparable long-term results.

Ipsilateral Combined Monteggia Type II Equivalent and Galeazzi Injuries with Radial Head Fracture in an Adult Patient – Case Report and Literature Review

We report the occurrence of a radial head fracture (Mason Johnston type 4), combined with a Monteggia type II equivalent fracture and Galeazzi fracture pattern in the same forearm of a 19-year-old man involved in a road traffic accident. Fractures of the radius and ulna bones were openly reduced and fixed; the radial head fracture was managed conservatively. The case was complicated by elbow dislocation and radioulnar instability, which was treated conservatively with a satisfactory outcome.

Galeazzi Fracture

Galeazzi fracture is a fracture of the radial diaphysis with disruption at the distal radioulnar joint (DRUJ). Typically, the mechanism of injury is forceful axial loading and torsion of the forearm. Diagnosis is established on radiographic evaluation. Underdiagnosis is common because disruption of the ligamentous restraints of the DRUJ may be overlooked. Nonsurgical management with anatomic reduction and immobilization in a long-arm cast has been successful in children. In adults, nonsurgical treatment typically fails because of deforming forces acting on the distal radius and DRUJ. Open reduction and internal fixation is the preferred surgical option. Anatomic reduction and rigid fixation should be followed by intraoperative assessment of the DRUJ. Further intraoperative interventions are based on the reducibility and postreduction stability of the DRUJ. Misdiagnosis or inadequate management of Galeazzi fracture may result in disabling complications, such as DRUJ instability, malunion, limited forearm range of motion, chronic wrist pain, and osteoarthritis.

Embrochage centromédullaire du radius dans les fractures récentes de Galeazzi chez l’adulte : À propos de 23 cas

Objectifs Consensual treatment of the Galeazzi's fracture is a plate osteosynthesis of the radius more or less associated to the confection of a plaster cast in distal radio-ulnar joint (DRUJ) dislocation. The authors are reporting in this study the clinical and functionnal results of the intra-medullary pinning of the radius in this type of fracture in adult. Methods During a prospective study from January 2003 to December 2006, 23 patients (20 men and three women), average-aged of 32 years (16–70 years) presenting with a Galeazzi's fracture were treated by an intra-medullary pinning of the radius. The DRUJ dislocations were locked 17 times by a brachio-ante-brachio-palmar plaster cast in the supination position, and six times by an ulno-radial pinning. Only the 16 over-aged patients presenting with closed recent fractures were included in this study. The DRUJ dislocation was ranked according to Mansat, the radial fracture according to Müller (AO). The assesment of the treatment results used Mestdagh's criteria. In this study, each pseudarthrosis of the radius was considered as a failure. Results The DRUJ dislocation was reparted into six sprains, eight subdislocations, and three Galeazzi's fracture equivalents. The radius fractures were simple ( n = 20) or wedge fractures ( n = 3). These fractures were located at the proximal third ( n = 13), middle third ( n = 7) and distal third ( n = 3). The average consolidation delay was 10 weeks (8 to16 weeks). Two pseudarthrosis have been observed and then treated by a plate osteosynthesis. At the mean follow up of 37 months (18 to 41 months), the mean score according to Mestdagh was 7.8 points, with 20 satisfying results. Nineteen patients were satisfied by their treatment; the reasons were: the esthetic care of their scar, and the good functionnal resumption, as well as before the fracture. Conclusion The intra-medullary pinning of radius in Galeazzi's fractures, in contrary to the previous studies, give good results compared to a plate osteosynthesis treatment. The systematic complementary lock by brachio-ante-brachio-palmar plaster cast during 3 to 4 weeks has balanced the stability defect that Mikic was reproaching to it. Moreover, it confers the benefits of elastic closed osteosynthesis. That less simple and less expensive method represents an alternative to a plate osteosynthesis in Galeazzi's fractures in adult, if it is well standardized.

A Case of Bilateral Galeazzi Fractures Associated with Dislocation of the Right Elbow

We report an unusual case of bilateral Galeazzi fractures associated with dislocation of the right elbow and fracture of the right scaphoid caused by a motorbike accident in a 32-year-old man. Bilateral radiuses were fixed with plates, and the right scaphoid was fixed with a screw after closed reduction of the right elbow. A satisfactory result was obtained with a return to work and no radiographic problems 7 years after surgery. The mechanism of the injury was thought to be a high-velocity fall on the outstretched hands combined with extreme pronation of the forearms and extension of the wrists and the elbows. This case had a favorable outcome following operative stabilization of the fracture-dislocations and early mobilization.

Fracture de Galeazzi avec luxation radio-ulnaire palmaire

The authors report the rare case of Galeazzi fracture with a volar distal radio-ulnar joint dislocation, as it is very important to restore exactly the anatomy with solid fixation of the radius fracture to achieve reduction of the ulnar head.

Ipsilateral Acute Monteggia Lesion and Malunion of Galeazzi Fracture in an Adult. A Case Report

Presentation of Monteggia and Galeazzi fractures in the same limb is a rare injury. We report an unusual case in which an acute Monteggia fracture was associated with a malunited Galeazzi fracture in an adult patient. The mechanism of this complex injury is discussed.