ABSTRACT
Distal radioulnar dislocation is commonly associated with radius fracture. Most common dislocation pattern is the dorsal dislocation. We present the unique case of volar dislocation of the distal radioulnar joint blocked by displaced dorsal Barton fracture of distal radius and discuss the injury mechanism and anatomic lesions.
Subject(s)
Joint Dislocations , Joints , Radius , Radius FracturesABSTRACT
Presentation of Monteggia and Galeazzi fractures in the same limb is a rare injury. We report an unusual case in which an acute Monteggia fracture was associated with a malunited Galeazzi fracture in an adult patient. The mechanism of this complex injury is discussed.
ABSTRACT
Galeazzi fractures in child is rare and seldom necessary of operative treatment because the result of conservative treatment is good. We present the patient who was a 11-year-old male and fell onto his both hands during a hundred-meter dash. His diagnosis was bilateral Galeazzi fractures and limited open reduction and internal fixation with Kirschner pins was initial treatment at local hospital. After 4 weeks postoperatively, Kirschner pins were removed and rehabilitating exercise was started. After 4 months postoperatively, he was transferred to our hospital due to malunion with severe angular deformities and distal radioulnar joint (DRUJ) dislocation. He was treated with corrective osteotomy. Thus, as in this case, we suggest more careful treatment and observation if conservative method of Galeazzi fracture in child is chosen and consider operative method as treatment according to age and pattern of fracture.
Subject(s)
Child , Humans , Male , Congenital Abnormalities , Joint Dislocations , Hand , Joints , OsteotomyABSTRACT
Galeazzis frature has been described as a fracture of the radius complicated by a dislocation of the distal radioulnar joint. This fracture, with angulation of the distal radius and dislocation of the distal radioulnar joint, shows the tendency to redisplacement after reduction due to a variety of factors including the brachioradialis muscle, the pronator quadratus muscle and the thumb abductors and extensors. Because of these factors, this fracture may rarely be treated by manipulation and plaster immobilization alone. The treatment of choice for Galeazzis fracture is open reduction and internal fixation. The author reviewed the cases of 28 patients with Galeazzis fracture who had been treated at the Department of Orthopedic Surgery, Yonsei University Wonju College of Medicie from January 1978 to December 1986. This study emphasized the nature of the injury, the level of the radial fracture, treatment and results. The results were as follows ; 1. The subjects included 2 children and 26 adults. Males were affected more frequently than females, and the sex ratio was 6: 1 2. The causes of injury included car accidents in ten cases(36%), falls in eight cases(29%), injuries from machinery in five cases(18%), direct blows in four cases(14%) and explosion in one case(3%). 3. The fracture occured most often at the junction of the middle and distal thirds of the radial shaft in thirteen cases(47%), and less often in the middle third of the radial shat, eitht cases(29%). Infrequent sites of fracture included the junction of the proximal and middle thirds in four cases(14%), the distal third in two cases(7%) and the proximal third of the radius in one case(3%). 4. Twenty-two cases(78%) experienced fracture composed of only two fragmented, but six cases(22%) were multifragment fractures. The frature was oblique and in one case, spiral. In twenty-two cases, the fractures were closed and in six cases, open. Three cases of open fractures had grade III soft tissue injuries. 5. Roentgenograpghic diagnosis of the distal radioulnar joint disruption was possible in 82% of the cases. 6. Associated injuries were noted in 57% of the cases including six cases of head injuries, four cases of head injuries, two cases of injury to the lower extremities, two cases of spinal injury, one cases of a fractured humerus. 7. Conservative treatment was given in five cases and operative treatment twenty-two cases. Conservative treatment gave excellent results in one case, fair results in two cases, while operative treatment resulted in an excellent outcome in thirteen cases, a fair outcome in eight cases and poor in one case. 8. Six cases experienced complications including delayed union in two cases, subluxation of the distal radioulnar joint in two cases, ahgulation in one case and infection in one case.