Galeazzi's Fracture

Galeazzi fractures and dislocations are injuries that combine a fracture of the distal third of the radius with a dislocation of the head of the ulna in the distal radial joint. Sooreg (1842) and R. Galeazzi (1934) contributed to the study of these lesions.

In 1942, Campbell called them "fractures of necessity," emphasizing the need for surgical intervention to restore normal anatomical relationships.

Galeazzi fractures and dislocations account for up to 7% of fractures of the forearm bones, they occur when falling on the hand in the pronation position with the transfer of force to the forearm. The components of the injury are ruptures of the square pronator of the forearm, the shoulder muscle, and the extensor tendons of the thumb.

Patients complain of pain in the middle and lower thirds of the forearm, limited movement in the wrist joint. There is pronounced swelling of soft tissues, subcutaneous hematoma. The superior head of the ulna is palpated under the skin. In severe cases, signs of forearm compartment syndrome (compression of arteries, veins, and nerves by damaged edematous soft tissues) may develop. Damage to the anterior interosseous nerve of the forearm, which innervates the long flexor of the thumb and the deep flexor of the fingers, is common. This leads to a violation of the mechanism of compression between the thumb and forefinger.

To clarify the diagnosis, it is necessary to perform an X-ray of the forearm in two projections with the capture of the wrist and elbow joints. In doubtful cases, radiography of an intact limb and computed tomography may be useful for planning surgery.

Galeazzi fractures and dislocations are indications for surgical treatment – open reposition and osteosynthesis of the radius diaphysis with a plate and, in case of unstable injuries, fixation of the ulnar head in the articular notch using a knitting needle. In severe cases with bone fragmentation, bone grafting may be required. In the postoperative period, immobilization in the supination position is required.