Clinical Study of Galeazzi's Fracture / 대한정형외과학회잡지

ABSTRACT

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.