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 Pt is 31yom who presents
after a bar room
altercation, in which he
was hit directly on the
forearm with a pool cue. Pt
is complaining of diffuse
left forearm pain and
swelling, as well as left
wrist pain. Pt’s arm is held
at side with elbow flexed,
and pt denies any other
injuries.
 T 98.4 P 94 BP 140/85 O2
99%
 MSK- diffuse soft tissue
swelling over dorsal aspect
of left forearm, no obvious
deformity or lacerations.
TTP over mid-forearm up
to wrist, with increased
pain at wrist with
flexion/extension
 Neuro- 5/5 strength
throughout, normal
sensation, 2+ distal pulses
Mid-shaft radial fx (red arrow) with disruption of DURJ (distal
ulnar/radial joint) [ blue arrow] Note the prominence of the distal ulna.
 Pain control
 Urgent Ortho consult, as ORIF of radius needed, as
well as open visualization of RU joint.
 Temporary reduction of radius recommended while
awaiting surgical consultation
 Compartment syndrome precautions
 “Fracture of necessity" -adult Galeazzi fracture is not
amenable to treatment by closed means, necessitating
surgical stabilization.
 Pediatric Galeazzi fx usually treated with closed reduction
and casting
 Fx is almost always located just above proximal border of
pronator quadratus
 Weight of hand tends to cause subluxation of distal RU
joint & dorsal angulation of the fx radius
 Brachioradialis causes shortening & rotation of distal RU
joint
 Mechanism usually FOOSH (specifically, a fall that causes
an axial load to be placed on a hyperpronated forearm) or
direct blow to forearm
 http://www.wheelessonline.com/ortho/galeazzis_fract
ure_adults_1
 http://www.mypacs.net/cases/GALEAZZI-
FRACTURE-RADIAL-SHAFT-FX--DISRUPTION-OF-
THE-DRUJ-ULNAR-STYLOID-FX-801523.html
 http://emedicine.medscape.com/article/1239331-
overview
 http://www.mskcases.com/index.php?module=article
&view=194
 http://www.ncbi.nlm.nih.gov/pubmed/8145315

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Galeazzi fracture Power Point

  • 1.
  • 2.  Pt is 31yom who presents after a bar room altercation, in which he was hit directly on the forearm with a pool cue. Pt is complaining of diffuse left forearm pain and swelling, as well as left wrist pain. Pt’s arm is held at side with elbow flexed, and pt denies any other injuries.  T 98.4 P 94 BP 140/85 O2 99%  MSK- diffuse soft tissue swelling over dorsal aspect of left forearm, no obvious deformity or lacerations. TTP over mid-forearm up to wrist, with increased pain at wrist with flexion/extension  Neuro- 5/5 strength throughout, normal sensation, 2+ distal pulses
  • 3.
  • 4. Mid-shaft radial fx (red arrow) with disruption of DURJ (distal ulnar/radial joint) [ blue arrow] Note the prominence of the distal ulna.
  • 5.  Pain control  Urgent Ortho consult, as ORIF of radius needed, as well as open visualization of RU joint.  Temporary reduction of radius recommended while awaiting surgical consultation  Compartment syndrome precautions
  • 6.  “Fracture of necessity" -adult Galeazzi fracture is not amenable to treatment by closed means, necessitating surgical stabilization.  Pediatric Galeazzi fx usually treated with closed reduction and casting  Fx is almost always located just above proximal border of pronator quadratus  Weight of hand tends to cause subluxation of distal RU joint & dorsal angulation of the fx radius  Brachioradialis causes shortening & rotation of distal RU joint  Mechanism usually FOOSH (specifically, a fall that causes an axial load to be placed on a hyperpronated forearm) or direct blow to forearm
  • 7.
  • 8.  http://www.wheelessonline.com/ortho/galeazzis_fract ure_adults_1  http://www.mypacs.net/cases/GALEAZZI- FRACTURE-RADIAL-SHAFT-FX--DISRUPTION-OF- THE-DRUJ-ULNAR-STYLOID-FX-801523.html  http://emedicine.medscape.com/article/1239331- overview  http://www.mskcases.com/index.php?module=article &view=194  http://www.ncbi.nlm.nih.gov/pubmed/8145315