It is useful to note that it is the head of the nonfractured bone that is dislocated. The fractured bone is switched, as is the dislocation. A galeazziequivalent fracture is a distal radial fracture with a distal ulnar physeal fracture 2. Galeazzi fractures recognizing the injury may be difficult when subtle should be suspected in all isolated radial shaft fractures, however. C an ulnar osteotomy and gradual lengthening with an external fixator resulted in a stable reduction 2 years later on plain film d and. There are several mnemonics for the difference between a galeazzi and a monteggia fracture dislocation. Monteggia and galeazzi fracturedislocations are unstable forearm injuries and represent 1%2% and 3%4% of forearm fractures, respectively 1, 2. Grimus helps to remember which forearm bone is fractured and whether the distal inferior or proximal superior part of the bone is involved.
Freedman et al reported a delayed open reduction of a type i monteggia lesion without annular ligament reconstruction but with ulnar osteotomy, radial shortening, and deepening of the radial notch of the ulna. Monteggia and galeazzi fractures account for 15% of total forearm fractures. A monteggia fracture consists of a combination of both. Bilateral combined monteggia and galeazzi fractures. Galeazzi and monteggia fracturedislocations mnemonic. Misdiagnosis or inadequate management of galeazzi fracture may result in disabling complications, such as druj instability, malunion, limited forearm range of motion, chronic wrist pain, and osteoarthritis. Monteggia fracture variant with plastic deformation. Direct blow on back of upper forearm would be a very uncommon cause. Monteggias fracture definition of monteggias fracture. In this context, isolated ulnar shaft fractures are most commonly seen in defence against blunt trauma e. There are four types, based on the direction that the radial head is displaced bado classification.
B arthrogram confirmed radial head dislocation at 14 months of age. A galeazzi fracture is a break of the radius between the midportion of the radius and the wrist. Wilson 1933 in new york and cunningham 1934 in oklahoma both presented large numbers of consecutive patients with elbow injuries and formally discussed. Further intraoperative interventions are based on the reducibility and postreduction stability of the druj. Such an isolated ulnar shaft fracture is not a monteggia fracture. Radial head dislocation, which is most commonly seen on an ap view of the elbow where the radial head is no longer lining up with the capitellum where the radiocapitellar line normally resides. There are several mnemonics for the difference between a galeazzi and a monteggia fracturedislocation. A combined monteggia and galeazzi fracture is an extremely rare injury. Whereas the galeazzi is a distal radius fracture with a distal ulnar dislocation which pulls the radioulnar joint apart, the monteggia is a proximal ulnar fracture with a proximal radial head dislocation. Keywords avulsion fractures casting and immobilization child abusenonaccidental trauma nat distal humerus physeal separation distal femur physeal fracture pediatric hip dislocation pediatric hip fracture humeral shaft fractures lateral condyle fracture medial epicondyle fracture pediatric ankle fractures pediatric forearm fracture pediatric clavicle fracture pediatric distal radius.
Galeazzi fracturedislocations consist of fracture of the distal part of the radius with dislocation of distal radioulnar joint and an intact ulna. A birth monteggia fracture variant with plastic deformation of the ulna. Pdf combined galeazzi and monteggia forearm fracture. Think of the monteggia fracture as the exact opposite of a galeazzi fracture. Treatment principles of galeazzi and monteggia fracturedislocations include anatomic reduction and fixation of all fractures, preservation of radiocapitellar contact, and managing the soft tissue injury either via direct repair or immobilization in a reduced position 1, 2, 3, 4. Monteggias fracture synonyms, monteggias fracture pronunciation, monteggias fracture translation, english dictionary definition of monteggias fracture. Other classifications letts et al devised a classification of monteggia fractures in children based on both the direction of the radial head dislocation and the type of ulnar fracture. Oner and diepstraten suggested that ulnar osteotomy is not necessary in type i lesions anterior dislocation, but in type iii lesions. Anatomic reduction, rigid fixation specific attention to the contour of the ulna grechenig w, clement h, pichler w, tesch np, windisch g. A fracture can be the complete or partial break of a bone. Gruesome murder helps us remember which bone is fractured and which one is dislocated.
An unusual variant of galeazzis fractureluxation involving the distal ulnar epiphysis, whose reduction was impeded by the interposition of the extensor carpi ulnaris ecu tendom. Monteggia fracture an overview sciencedirect topics. Isolated radial shaft fractures are more common than galeazzi fractures. A galeazzi fracture is a fracture of the distal radius with dislocation of the. Druj injury not present in majority of isolated radial shaft fractures ring, et al. Galeazzi fracture dislocations consist of fracture of the distal part of the radius with dislocation of distal radioulnar joint and an intact ulna.
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