In a Galeazzi fracture-dislocation the radial shaft wedge fracture is associated with a dislocation of the ulna at the distal radioulnar joint (DRUJ).
Most often, the dislocation is dorsal, very seldom, the dislocation is volar.
Accurate reduction of the radial fracture usually leads to spontaneous reduction of the distal ulna. In Galeazzi fracture-dislocations, anatomical reduction and stable fixation are mandatory. The radial fracture must be anatomically reduced in order to ensure accurate reduction of the ulnar head.
Nonoperative treatment is only undertaken if surgery is not possible.
Intramedullary nailing of forearm fractures is currently limited to pediatric fractures and severe multifragmentary injuries of one or both forearm bones in the presence of devastating soft-tissue damage. Pediatric fractures are not included in this module of AO Surgery Reference. Discussion of nailing in adult forearm shaft fractures is confined to multifragmentary fractures of both bones in adult AO Surgery Reference.
Once operative fixation is achieved, the surgeon must ensure reduction and stability of the ulnar head, preferably under image intensification.
|A means of temporary fixation for severely open fractures|
External fixation can be indicated in severely open fractures as means of temporary fixation (with a view to later conversion to internal fixation).
|ORIF - Compression plating|
|Treatment of choice|
In Galeazzi fracture-dislocations, anatomical reduction and stable fixation are mandatory. This is best achieved by compression plating.
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|