Isolated fracture of the radius may occur as such or associated with injury to distal radio ulnar joint. This kind of fracture that is associated with injury to distal radio ulnar joint is called Galleazi Fracture.
A fracture of the similar pattern involving ulna and proximal radio ulnar joint is called Monteggia Fracture. Galeazzi fracture is three times more than Monteggia fracture.
Mechanism of injury
Galeazzi fracture usually occurs due to either direct blows on the dorsolateral side of the wrist or fall on the hand.
The most probable mechanism of injury in Galeazzi’s fracture is a fall on the outstretched hand combined with marked pronation of the forearm.
Clinical Presentation
the severity of the symptoms varies with severity of injury and the degree of displacement.
In minimally displaced fractures, the presenting symptom may just be pain, swelling and tenderness about the fracture. In case of displaced fractures, there would be dformity in the forearm as well. Associated subluxation or dislocation of the distal radioulnar joint may show as prominence of the head of the ulna and there is tenderness over the joint.
Elbow should be examined to rule out any concomitant injury.
Radiographs
Anteropsterior and lateral radiographs of the forearm should be done including both elbow and wrist joints. The xrays help to determine the level of the fracture, configuration of the fracture and associated distal radioulnar joint injury.
The injury to the radioulnar joint may be purely ligamentous, or the ulnar styloid may be avulsed.
Except for undisplaced fractures, most fractures of the radius have associated distal radioulnar joint pathology or damage to the interosseous membrane.
Fractures of the shaft of the radius can be divided into two groups
- Fractures in the proximal two-thirds of the bone. these fractures are not associated with injury to the distal radioulnar joint
- At junction of the middle and distal thirds that are. Most of these fractures are associated with injury to the distal radioulnar joint.
Treatment
Though rare, undisplaced fracture of the shaft of the radius can be managed with above elbow cast immobilization. Patient should be followed up with xrays every week to not for the displacement of the fracture. If it gets displaced it should be treated as displaced fracture.
Displaced fractures do not yield good results with closed reduction and plaster cast application. Open reduction and internal fixation using plate and screws is the preferred treatment. Distal radioulnar joint should be assessed after the fixation and if required can be gioven a temporary stabilization.
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