Galeazzi fracture-dislocation: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
*PA: May only show slightly increased distal radioulnar joint space | *Inspect skin for signs of open fracture | ||
*Lateral: Ulna is displaced dorsally | *Assess distal pulses, motor, and sensation | ||
*Imaging: Plain radiographs<ref>Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33</ref> | |||
**PA: May only show slightly increased distal radioulnar joint space | |||
**Lateral: Ulna is displaced dorsally | |||
[[File:Galeazzi fx.jpeg|thumb|Galeazzi Fracture]] | [[File:Galeazzi fx.jpeg|thumb|Galeazzi Fracture]] | ||
| Line 20: | Line 23: | ||
*[[Long arm posterior splint]] with elbow flexed 90° and forearm '''pronated''' | *[[Long arm posterior splint]] with elbow flexed 90° and forearm '''pronated''' | ||
**Linked image indicates neutral position of forearm, rather than pronation | **Linked image indicates neutral position of forearm, rather than pronation | ||
===Pediatrics=== | |||
*Can manage with closed reduction if DRUJ stable after splinting | |||
==Disposition== | ==Disposition== | ||
*If splinted and stabilized, can be discharged after consultation with Ortho | *If splinted and stabilized, can be discharged after consultation with Ortho<ref>Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33</ref> | ||
**Will need close follow-up for likely operative repair | **Will need close follow-up for likely operative repair | ||
* | ===Admit for<ref>Atesok KI, Jupiter JB, Weiss AP. Galeazzi fracture. J Am Acad Ortho Surg 2011; 19: 623-33</ref>=== | ||
*[[Open fracture]] | |||
*Signs of neurovascular injury | |||
*Concern for [[compartment syndrome]] | |||
==See Also== | ==See Also== | ||
*[[Forearm Fracture]] | *[[Forearm Fracture]] | ||
==External Links== | |||
*http://radiopaedia.org/articles/galeazzi-fracture-dislocation | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
Latest revision as of 18:12, 17 March 2018
Background
- Radius fracture (distal third) + distal radioulnar dislocation
- Concurrent Ulnar Styloid fracture is common
- Caused by FOOSH with flexed elbow or direct blow
- Arm equivalent of a Maisonneuve fracture
Clinical Features
- Localized tenderness/swelling over distal radius/wrist
Differential Diagnosis
Forearm Fracture Types
- Distal radius fractures
- Radia ulna fracture
- Isolated radius fracture (proximal)
- Isolated ulna fracture (i.e. nightstick)
- Monteggia fracture-dislocation
- Galeazzi fracture-dislocation
- Forearm fracture (peds)
Evaluation
- Inspect skin for signs of open fracture
- Assess distal pulses, motor, and sensation
- Imaging: Plain radiographs[1]
- PA: May only show slightly increased distal radioulnar joint space
- Lateral: Ulna is displaced dorsally
Management
- Consult ortho in the ED; likely requires ORIF
- Long arm posterior splint with elbow flexed 90° and forearm pronated
- Linked image indicates neutral position of forearm, rather than pronation
Pediatrics
- Can manage with closed reduction if DRUJ stable after splinting
Disposition
- If splinted and stabilized, can be discharged after consultation with Ortho[2]
- Will need close follow-up for likely operative repair
Admit for[3]
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome