The Galeazzi fracture is a fracture of the radius

Radius (bone)

The radius is one of the two large bones of the forearm, the other being the ulna. It extends from the lateral side of the elbow to the thumb side of the wrist and runs parallel to the ulna, which exceeds it in length and size. It is a long bone, prism-shaped and slightly curved longitudinally...

 with dislocation of the distal radioulnar joint. It classically involves an isolated fracture of the junction of the distal third and middle third of the radius with associated subluxation

Subluxation

A subluxation may have different meanings, depending on the medical specialty involved. It implies the presence of an incomplete or partial dislocation of a joint or organ. The World Health Organization defines both the medical subluxation and the chiropractic subluxation...

 or dislocation

Dislocation

In materials science, a dislocation is a crystallographic defect, or irregularity, within a crystal structure. The presence of dislocations strongly influences many of the properties of materials...

 of the distal radio-ulnar joint; the injury disrupts the forearm axis joint.

History

The Galeazzi fracture is named after Ricardo Galeazzi

Ricardo Galeazzi

Professor Ricardo Galeazzi was an Italian orthopaedic surgeon remembered for describing the Galeazzi fracture.He was director of the orthopaedic clinic at the University of Milan for thirty five years...

 (1866–1952), an Italian surgeon at the Instituto de Rachitici in Milan, who described the fracture in 1934. However, it was first described 1842, by Cooper, 92 years before Galeazzi reported his results.

Epidemiology

Galeazzi fractures account for 3-7% of all forearm fractures. They are seen most often in males. Although Galeazzi fracture patterns are reportedly uncommon, they are estimated to account for 7% of all forearm fractures in adults. They are associated with fall on out-stretched arm.

Signs and symptoms

Pain and soft-tissue swelling are present at the distal-third radial fracture site and at the wrist joint. This injury is confirmed on radiographic evaluation. Forearm trauma may be associated with compartment syndrome

Compartment syndrome

Compartment syndrome is a limb threatening and life threatening condition, defined as the compression of nerves, blood vessels, and muscle inside a closed space within the body . This leads to tissue death from lack of oxygenation due to the blood vessels being compressed by the raised pressure...

. Anterior interosseous nerve

Anterior interosseous nerve

The anterior interosseous nerve is a branch of the median nerve that supplies the deep muscles on the front of the forearm, except the ulnar half of the flexor digitorum profundus....

 (AIN) palsy may also be present, but it is often overlooked because there is no sensory component to this finding. A purely motor nerve, the AIN is a division of the median nerve. Injury to the AIN can cause paralysis of the flexor pollicis longus and flexor digitorum profundus muscles to the index finger, resulting in loss of the pinch mechanism between the thumb and index finger. Galeazzi fractures are sometimes associated with wrist drop

Wrist drop

Wrist drop, also known as radial nerve palsy, or Saturday night palsy, is a condition where a person cannot extend their wrist and it hangs flaccidly. To demonstrate wrist drop, hold your arm out in front of you with your forearm parallel to the floor. With the back of your hand facing the...

 due to injury to radial nerve

Radial nerve

The radial nerve is a nerve in the human body that supplies the upper limb. It supplies the medial and lateral heads of the triceps brachii muscle of the arm, as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin.It...

, extensor tendons or muscles. They are the most likely fractures to go for malunion.

Pathophysiology

The etiology of the Galeazzi fracture is thought to be a fall that causes an axial load to be placed on a hyperpronated forearm. However, researchers have been unable to reproduce the mechanism of injury in a laboratory setting.

After the injury, the fracture is subject to deforming forces including those of the brachioradialis

Brachioradialis

Brachioradialis is a muscle of the forearm that acts to flex the forearm at the elbow. It is also capable of both pronation and supination, depending on the position of the forearm...

, pronator quadratus

Pronator quadratus

Pronator quadratus is a square shaped muscle on the distal forearm that acts to pronate the hand.As it is on the anterior side of the arm, it is innervated by a branch of the median nerve, the anterior interosseous nerve...

, and thumb extensors, as well as the weight of the hand. The deforming muscular and soft-tissue injuries that are associated with this fracture cannot be controlled with plaster immobilization.

Treatment

Galeazzi fractures are best treated with open reduction of the radius and the distal radio-ulnar joint. It has been called the "fracture of necessity," because it necessitates open surgical treatment in the adult. Nonsurgical treatment results in persistent or recurrent dislocations of the distal ulna. However, in skeletally immature patients such as children, the fracture is typically treated with closed reduction.

External links

• Radiographs of Galeazzi Fracture - gentili.net
• X-rays of a Galeazzi fracture - learningradiology.com