Galeazzi Fracture: Definition:
- Fracture of the shaft of radius (most commonly at the junction of the middle and distal thirds) with dislocation of distal radioulnar joint (DRUJ)
Mechanism:
- Direct wrist trauma
- Fall onto outstretched hand with forearm in pronation
Treatment:
- Operative:
- ORIF of radius with reduction and stabilization of DRUJ. Anatomic reduction of DRUJ is required. Acute operative treatment far superior to late reconstruction
Complications:
- Compartment syndrome: increased risk with high energy crush injuries
- Neurovascular injury: uncommon except type III open fractures
Monteggia fracture:
Definition:
- Fracture of the proximal portion of the ulna combined with dislocation of the radial head.
Epidemiology:
- Rare in adults
- More common in children with peak incidence between 4 and 10 years of age
Mechanism:
- Fall on an outstretched hand with the forearm in excessive pronation (hyper-pronation injury)
Prognosis:
- If diagnosis is delayed greater than 2-3 weeks complication rates increase significantly
Treatment:
- Nonoperative
o Closed reduction
- indications
- more common and successful in children
- Operative
o ORIF
- indications
- acute fractures which are open or unstable
- comminuted fractures
- Most Monteggia fractures in adults are treated surgically
o IM Nailing of the ulna
- Indications
- transverse or short oblique fracture
Confusing right? Well... Just Remember "MuGGeR"!!
Sources: Ortho Bullets, Life in the Fastlane, InTrainingPrep