Pronation type Galeazzi-equivalent fracture

Abstract

Rationale: Galeazzi fractures are uncommon, and are less common in children than in adults. Galeazzi-equivalent fractures, a variant of the classic Galeazzi fractures, mostly occur in children or adolescents. Galeazzi equivalent fractures may commonly accompany distal radial fractures or injury of the epiphyseal plate of the distal ulna.Patient concerns: A 13-year-old man visited our emergency department after stumbling over a rock. Manual reduction and splinting was already done in a nearby medical center. Plain radiographs revealed fractures in the distal radius and fracture of the ulnar epiphyseal plate.Diagnosis: Plain radiographs showed Galeazzi-equivalent fracture. The result of primary closed reduction was not enough and there was still displacement of fracture.Interventions: Anatomical reduction of distal radius was fixed with a plate and screws, and K-wires were inserted percutaneously for reduction and fixation of ulnar fracture.Outcomes: Complete bone union was achieved and normal range of motion is shown 2 years postoperatively. The patient is able to perform daily activities and sport activities without any signs of ulnar growth arrest.Lessons: Open reduction is required in patients with malalignment, failure to reduce the DRUJ or maintain its reduction, or older ages which are hard to expect sufficient bone remodeling.Abbreviations: DASH = the disabilities of the arm, shoulder, and hand, DRUJ = distal radioulnar joint.

Pronation-Type Galeazzi-Equivalent Fracture: A Case Report

“…In contrast to Ashish's case, a case of pronation pattern injury reported by Chae and Kwon had difficulties in a close reduction for a radius fracture due to soft tissue interposition; however, a close reduction for the ulnar epiphyseal fracture was achieved and fixed using a percutaneous pinning technique [ 9 ]. In our case, the close reduction was unsatisfying, with an unstable fracture pattern.…”

“…Open reduction and internal fixation of the distal radius fracture were achieved, as the stabilized anatomical reduction of the radius fracture facilitated distal ulna physeal fracture reduction [ 7 ]. Considering the patient was older than most children who have the same injury pattern, he had limited potential for bone remodeling, with less than two years of growth remaining [ 9 , 10 ]. However, the ulnar epiphyseal fracture was irreducible by close reduction after stabilizing the radius fracture.…”

Case report of Galeazzi like fracture associated with fracture of the scaphoid, Rolando fracture and avulsion of the inserting site of the extensor carpi ulnaris

“…In adults, type 1 fractures are triggered by the axial loading to the supinated wrist joint, which results in dorsal displacement of the radius and volar dislocation of the distal ulna. Type 2 fractures are triggered by axial loading to the pronated wrist joint, resulting in volar displacement of the radius and dorsal dislocation of the distal ulna [6] Bony architecture only accounts for approximately 20% of the DRUJ's stability. The remainder of the stability is afforded by the surrounding soft tissue.…”