Galeazzi fracture (1)

Galeazzi fracture (1)

• 2.
   Pt is31yom who presents  T 98.4 P 94 BP 140/85 O2 after a bar room 99% altercation, in which he  MSK- diffuse soft tissue was hit directly on the swelling over dorsal aspect forearm with a pool cue. Pt of left forearm, no obvious is complaining of diffuse deformity or lacerations. left forearm pain and TTP over mid-forearm up swelling, as well as left to wrist, with increased wrist pain. Pt’s arm is held pain at wrist with at side with elbow flexion/extension flexed, and pt denies any  Neuro- 5/5 strength other injuries. throughout, normal sensation, 2+ distal pulses
• 4.
  Mid-shaft radial fx(red arrow) with disruption of DURJ (distal ulnar/radial joint) [ blue arrow] Note the prominence of the distal ulna.
• 5.
   Pain control Urgent Ortho consult, as ORIF of radius needed, as well as open visualization of RU joint.  Temporary reduction of radius recommended while awaiting surgical consultation  Compartment syndrome precautions
• 6.
   “Fracture ofnecessity" -adult Galeazzi fracture is not amenable to treatment by closed means, necessitating surgical stabilization.  Pediatric Galeazzi fx usually treated with closed reduction and casting  Fx is almost always located just above proximal border of pronator quadratus  Weight of hand tends to cause subluxation of distal RU joint & dorsal angulation of the fx radius  Brachioradialis causes shortening & rotation of distal RU joint  Mechanism usually FOOSH (specifically, a fall that causes an axial load to be placed on a hyperpronated forearm) or direct blow to forearm
• 8.
   http://www.wheelessonline.com/ortho/galeazzis_fract ure_adults_1  http://www.mypacs.net/cases/GALEAZZI- FRACTURE-RADIAL-SHAFT-FX--DISRUPTION-OF- THE-DRUJ-ULNAR-STYLOID-FX-801523.html  http://emedicine.medscape.com/article/1239331- overview  http://www.mskcases.com/index.php?module=article &view=194  http://www.ncbi.nlm.nih.gov/pubmed/8145315