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Subacute dislocation of the elbow following Galeazzi fracture-dislocation of the radius: A case report.

Rajeev A, Senevirathna S, Harrison J - J Med Case Rep (2011)

Bottom Line: He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius.However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair.This can lead to instability of the elbow joint.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK. shanaka_s2004@yahoo.com.

ABSTRACT

Introduction: The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions) or both. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. To the best of our knowledge, this has not been previously reported in the English literature.

Case presentation: A 26-year-old Caucasian man presented to our department after a fall from a motorbike. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Post-operative radiographs films were satisfactory. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Our patient was noted to have full elbow and forearm function at three months.

Conclusions: Although the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. This can lead to instability of the elbow joint. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation.

No MeSH data available.


Related in: MedlinePlus

Radiographs at initial presentation show a comminuted fracture of the right radial shaft (junction of middle and distal thirds) and distal radioulnar joint (DRUJ) dislocation but no evidence of elbow dislocation.
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Figure 1: Radiographs at initial presentation show a comminuted fracture of the right radial shaft (junction of middle and distal thirds) and distal radioulnar joint (DRUJ) dislocation but no evidence of elbow dislocation.

Mentions: A 26-year-old Caucasian man presented to our department with an isolated right forearm injury, which he sustained after falling off his motorbike. His main complaint was of a painful and clinically deformed right forearm. A clinical examination revealed a closed and neurovascularly intact injury with bony tenderness and inability to move the right forearm. Radiographs showed a comminuted fracture of the right shaft of the radius (at the junction of the middle and distal thirds) with an associated DRUJ dislocation but no evidence of elbow dislocation (Figure 1).


Subacute dislocation of the elbow following Galeazzi fracture-dislocation of the radius: A case report.

Rajeev A, Senevirathna S, Harrison J - J Med Case Rep (2011)

Radiographs at initial presentation show a comminuted fracture of the right radial shaft (junction of middle and distal thirds) and distal radioulnar joint (DRUJ) dislocation but no evidence of elbow dislocation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3285057&req=5

Figure 1: Radiographs at initial presentation show a comminuted fracture of the right radial shaft (junction of middle and distal thirds) and distal radioulnar joint (DRUJ) dislocation but no evidence of elbow dislocation.
Mentions: A 26-year-old Caucasian man presented to our department with an isolated right forearm injury, which he sustained after falling off his motorbike. His main complaint was of a painful and clinically deformed right forearm. A clinical examination revealed a closed and neurovascularly intact injury with bony tenderness and inability to move the right forearm. Radiographs showed a comminuted fracture of the right shaft of the radius (at the junction of the middle and distal thirds) with an associated DRUJ dislocation but no evidence of elbow dislocation (Figure 1).

Bottom Line: He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius.However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair.This can lead to instability of the elbow joint.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK. shanaka_s2004@yahoo.com.

ABSTRACT

Introduction: The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions) or both. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. To the best of our knowledge, this has not been previously reported in the English literature.

Case presentation: A 26-year-old Caucasian man presented to our department after a fall from a motorbike. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Post-operative radiographs films were satisfactory. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Our patient was noted to have full elbow and forearm function at three months.

Conclusions: Although the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. This can lead to instability of the elbow joint. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation.

No MeSH data available.


Related in: MedlinePlus