A Case of Bilateral Galeazzi Fracture-Dislocations

Abstract

Bilateral Galeazzi fracture-dislocations are extremely rare injuries and only a few case reports have been described so far in the literature. Herein, we report the case of a 31-year-old bicyclist who sustained bilateral Galeazzi fracture-dislocations after a collision with a car. Both radial shaft fractures were simple (AO type 22-A2.3), at the same level (Type I: <7.5 cm from the joint line), and without severe comminution having their apex located dorsally. Internal fixation was accomplished in both fractures with an 8-hole, 3.5-mm locking plate; the stability of the distal radioulnar joint (DRUJ) was assessed with several intraoperative tests and found to be stable so that no additional stabilization was necessary. Postoperatively, the forearms were immobilized in a long forearm cast for four weeks. At the last follow-up evaluation, six years postoperatively, the patient was pain-free, had a full range of motion with a total Mayo wrist score of 95 in both wrists. Bilateral Galeazzi fracture-dislocations are rare injuries requiring proper radial fracture management and thorough assessment of DRUJ stability.

The role of arthroscopic triangular fibrocartilage complex repair in a case of bilateral Galeazzi fracture-dislocation

“…Galeazzi fractures are relatively rare, representing less than 7% of adult forearm fractures [8]. Bilateral Galeazzi fracture-dislocations in adults are extremely rare, and only six case reports have been described so far (Table 1) [3][4][5]7,9,10]. Including our case, all previously published cases were male patients in their 20s and 30s who had high-energy injuries.…”

“…However, there was little agreement concerning the treatment of the DRUJ, mainly stabilized by triangular fibrocartilage complex (TFCC) [3,4]. Various techniques exist for managing the DRUJ problem after radius fixation, including immobilization alone [3,5], transfixing Kirschner wires, ulnar styloid fixation [4,6], and TFCC repair [7]. Finally, the optimal treatment approach remains debated and tends to be considerably chosen by the surgeon's knowledge and experience [1,8].…”

Elbow Dislocation With Associated Essex-Lopresti Injury: A Case Treated Conservatively

“…Ultrasound and MRI are also highly sensitive and considered the golden standard for diagnosing IOM lesions [ 9 ]. The Tilt test, the piano key sign, the radius pull test, the ulnocarpal stress test, and the ballottement test can be used to assess for DRUJ instability clinically, whereas intraoperative assessment can assist the final decision [ 5 , 10 ]. Bilateral wrist X-rays are of high value to assess for proximal radius migration in comparison to the normal wrist and should be ordered after radial head fractures [ 10 - 11 ].…”

“…The Tilt test, the piano key sign, the radius pull test, the ulnocarpal stress test, and the ballottement test can be used to assess for DRUJ instability clinically, whereas intraoperative assessment can assist the final decision [ 5 , 10 ]. Bilateral wrist X-rays are of high value to assess for proximal radius migration in comparison to the normal wrist and should be ordered after radial head fractures [ 10 - 11 ]. Proximal radial migration of more than 1.9mm should raise suspicion of IOM and ulnocarpal ligament complex and a forearm MRI should be ordered [ 11 ].…”