Galeazzi fracture dislocation
Causes / typical injury mechanism:
Galeazzi fracture dislocation (named for Riccardo Galeazzi, who published a case series describing this injury pattern in 1934) is defined as a fracture of the distal radial shaft
with associated disruption of the distal radioulnar joint (DRUJ).
The mechanism of this acute injury is forceful axial loading of the forearm with the wrist in extension and typically maximum pronation (but possibly supination), such as when catching oneself during a fall. Other reported mechanisms of injury include motor vehicle accidents, athletics, and falls from a height. Classic history and presentation:
Look for forearm / wrist pain, swelling, and deformity following trauma. Prevalence:
The incidence is less than or equal to 3% of all forearm fractures in children and less than or equal to 7% of all forearm fractures in adults.Grade / classification system: Raskin / Rettig Galeazzi fracture-dislocation classification –
- Type 1: Less than 7.5 cm from distal radius articular surface
- 55% chance of DRUJ instability requiring fixation
- Type 2: Greater than 7.5 cm from distal radius articular surface
- 6% chance of DRUJ instability requiring fixation
S52.379A – Galeazzi's fracture of unspecified radius, initial encounter for closed fracture
271576001 – Galeazzi fracture dislocation
Differential Diagnosis & Pitfalls
Misdiagnosis or inappropriate treatment of Galeazzi fractures may result in malunion of the radius, chronic instability or subluxation of the DRUJ, persistent pain, limited forearm rotation, or weak grip strength. In these cases, an orthopedic surgeon may perform late bony correction or stabilization procedures to relieve pain and restore motion as able. However, function and anatomy will likely never be normal.