Galeazzi fracture
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| Galeazzi fracture | |
|---|---|
| Synonyms | Piedmont fracture |
| Pronounce | |
| Specialty | Orthopedic surgery |
| Symptoms | Pain, swelling, deformity of the forearm |
| Complications | Compartment syndrome, nerve injury |
| Onset | Sudden, typically due to trauma |
| Duration | Varies, depending on treatment |
| Types | |
| Causes | Fall on an outstretched hand, direct blow |
| Risks | Contact sports, motor vehicle accidents |
| Diagnosis | Physical examination, X-ray |
| Differential diagnosis | Monteggia fracture, Essex-Lopresti injury |
| Prevention | Use of protective gear, fall prevention strategies |
| Treatment | Surgical fixation |
| Medication | Pain management |
| Prognosis | Generally good with proper treatment |
| Frequency | Rare |
| Deaths | N/A |
A Galeazzi fracture is a type of bone fracture affecting the radius, one of the two large bones in the forearm. This injury is characterized by a fracture of the radial shaft along with dislocation of the distal radioulnar joint (DRUJ), making it a complex injury that requires prompt and effective treatment to restore forearm and wrist function. The condition is named after Riccardo Galeazzi, an Italian surgeon who described the fracture in detail in 1934.
Causes
Galeazzi fractures typically occur due to a fall on an outstretched hand with the wrist in radial deviation, or through direct trauma to the forearm. This mechanism of injury places excessive force on the radius, which can lead to its fracture and subsequent disruption of the DRUJ.
Symptoms
Patients with a Galeazzi fracture may present with pain, swelling, and deformity in the mid-forearm region. There is often marked tenderness over the site of the radial fracture and the distal radioulnar joint. Limited range of motion in the wrist, particularly in pronation and supination (rotation of the forearm), is also common.
Diagnosis
Diagnosis of a Galeazzi fracture is primarily based on physical examination and radiographic studies. X-rays of the forearm and wrist are essential to confirm the presence of the radial fracture and assess the dislocation of the DRUJ. In some cases, advanced imaging techniques such as Computed Tomography (CT) scans may be required to evaluate the extent of the injury and plan for surgery.
Treatment
Treatment of Galeazzi fractures usually involves surgical intervention to realign the fractured radius and stabilize the DRUJ. This typically includes open reduction and internal fixation (ORIF) of the radius with plates and screws. The DRUJ may also need to be reduced and stabilized, depending on the severity of the dislocation. Postoperative management includes immobilization of the forearm and wrist in a splint or cast, followed by a period of rehabilitation to restore function and strength.
Prognosis
With appropriate treatment, most patients with Galeazzi fractures can expect a good prognosis and return to normal activities. However, complications such as residual instability of the DRUJ, nerve injury, and post-traumatic arthritis can occur, potentially leading to long-term functional impairment.
Prevention
Preventing Galeazzi fractures involves minimizing the risk of falls and trauma to the forearm. This includes using protective gear during sports and other high-risk activities, and ensuring safe environments to reduce the likelihood of falls.
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Contributors: Prab R. Tumpati, MD