GALEAZZI FRACTURE-DISLOCATION OF THE RADIUS

Mechanism of injury

This injury was first described in 1934 by Galeazzi. The usual cause is a fall on the hand; probably with a superimposed rotation force. The radius fractures in its lower third and the inferior radio-ulnar joint subluxates or dislocates.

Clinical features

The Galeazzi fracture is much more common than the Monteggia. Prominence or tenderness over the lower end of the ulna is the striking feature. It may be possible to demonstrate the instability of the radio-ulnar joint by ‘ballotting’ the distal end of the ulna (the ‘piano-key sign’) or by rotating the wrist. It is important also to test for an ulnar nerve lesion, which may occur.

X-ray 

A transverse or short oblique fracture is seen in the lower third of the radius, with angulation or overlap. The distal radio-ulnar joint is subluxated or dislocated.

Treatment

As with the Monteggia fracture, the important step is to restore the length of the fractured bone. In children, closed reduction is often successful; in adults, reduction is best achieved by open operation and

compression plating of the radius. An x-ray is taken to ensure that the distal radio-ulnar joint is reduced. 

There are three possibilities:

1.  The distal radio-ulnar joint is reduced and stable.

   No further action is needed. The arm is rested for a few days, then gentle active movements are encouraged. The radio-ulnar joint should be checked, both clinically and radiologically, during the next 6 weeks.

2.  The distal radio-ulnar joint is reduced but unstable .

   The forearm should be immobilized in the position of stability (usually supination), supplemented if required by a transverse K-wire.The forearm is splinted in an above-elbow cast for 6 weeks. If there is a large ulnar styloid fragment, it should be reduced and fixed.

3.  The distal radio-ulnar joint is irreducible.

   This is unusual. Open reduction is needed to remove the interposed soft tissues. The triangular fibrocartilage complex (TFCC) and dorsal capsule are then carefully repaired and the forearm immobilized in the position of stability (again, usually supination, supported by a wire if needed) for 6 weeks.

---from 《Apley’s System of Orthopaedics and Fractures》

重點詞匯整理：

superimposed/,s?p?r?m'poz/adj. [地物] 疊加的；上疊的；重迭的；疊覆的，重疊的

inferior /?n?f?ri?r/n. 下級；次品adj. 差的；自卑的；下級的，下等的

Prominence or tenderness over the lower end of the ulna is the striking feature.尺骨下端突出或壓痛是其顯著特征。

Prominence /?prɑ?m?n?ns/n. 突出；顯著；突出物；卓越

 striking feature顯著特征

subluxated or dislocated.半脫位或脫位

supination/,sju:pi'nei??n/n. 旋后；反掌姿勢

styloid /?sta??l??d/n. 莖突adj. 莖突的；莖狀的；尖長的；針狀的；筆形

 The triangular fibrocartilage complex 三角形纖維軟骨復合體

dorsal capsule背部關節(jié)囊

百度翻譯：

橈骨GALEAZZI骨折脫位

損傷機制

這種損傷最早是在1934年由Galeazzi描述的。通常的原因是手上摔了一跤；可能是由于旋轉力的疊加。橈骨下三分之一及下橈尺關節(jié)骨折脫位或脫位。

臨床特征

Galeazzi骨折比Monteggia骨折更常見。尺骨下端突出或壓痛是其顯著特征。通過“抽簽”尺骨遠端（“鋼琴鍵符號”）或旋轉手腕，可能有助于顯示橈尺關節(jié)的不穩(wěn)定性。對可能發(fā)生的尺神經損傷進行檢測也很重要。

X射線

橈骨下三分之一處可見橫形或短斜形骨折，有成角或重疊。橈尺關節(jié)遠端半脫位或脫位。

治療

與孟氏骨折一樣，重要的一步是恢復骨折的長度。對于兒童，閉合復位通常是成功的；對于成人，復位最好通過開放手術和

半徑的壓縮電鍍。為了確保遠端橈尺關節(jié)復位，需要進行x光檢查。

有三種可能性：

1橈尺骨遠端關節(jié)復位穩(wěn)定，無需進一步手術。手臂休息幾天，然后鼓勵輕柔的活動。在接下來的6周內，應進行尺橈關節(jié)的臨床和放射學檢查。

2橈尺骨遠端關節(jié)減少但不穩(wěn)定前臂應固定在穩(wěn)定的位置（通常為旋后位），如果需要橫向K形位，則予以補充-電線。那個前臂用夾板固定在肘部上方，持續(xù)6周。如果尺骨莖突有較大的碎片，應予以復位固定。

3。橈尺骨遠端關節(jié)不能復位這是不尋常的。需要切開復位以去除插入的軟組織。然后仔細修復三角纖維軟骨復合體（TFCC）和背囊，并將前臂固定在穩(wěn)定位置（同樣，通常是旋后位，必要時用鋼絲支撐）6周。