The Galeazzi-Equivalent Lesion in Children Revisited

Abstract

A fracture at the medial end of the distal third of the radius with an epiphyseal separation of the distal ulna in a 16-year-old boy is described. This injury, known as the Galeazzi-equivalent lesion in children, is characterized by complete distal ulnar epiphyseal separation without rupture of the distal ligamentous stabilizing system between the radius and ulna, which includes the triangular fibrocartilage complex, interosseous ligaments and periosteal tube of the ulnar. The Galeazzi fracture-dislocation and the Galeazzi-equivalent lesion appear to be completely dissimilar in their pathological anatomy. We suggest calling the latter a "pseudo-Galeazzi injury".

Infrequent physeal wrist injury of the ulna and radius: a case report

“…These traumatic lesions are misdiagnosed in around 41% of the cases, coinciding with physeal wrist injuries and resulting in instability, functional loss of ROM and ocassionaly important cosmetic alterations [ 4 , 5 , 14 ]. The closed reduction was impossible in this patient due to soft tissue interposition of the ECU and an open reduction was necessary before internal fixation [ 1 , 11 , 12 , 15 ]. In these injuries at wrist joint, the information provided exclusively from conventional radiology is incomplete.…”

Traumatic Separation of the Distal Ulnar Physis in Children

“…1). 10,12,[16][17][18][19] Our study adds another 5 cases with ECU entrapment in the fracture site that required open reduction and internal fixation. Many case reports described the soft tissue entrapment in volarly-flexed adolescent Galeazzi-equivalent injuries (Table 4).…”

“…4 Galeazzi fractures in children are less common than in adults, 4,5 and rarely require surgical stabilization. 4,[8][9][10][11][12] However, a comparison between the dorsi-and volar-flexion Galeazziequivalent injuries has not been reported in the literature. Volar angulation of the distal radius and ulna have been reported to cause a high rate of soft tissue interposition, necessitating an open procedure to restore proper bony alignment.…”

Un faux équivalent de Galeazzi chez l’enfant. À propos d’un cas

“…Si ce n'est pas possible, une réduction à ciel ouvert s'impose. Un complément par attelle brachio-antibrachiopalmaire en supination est nécessaire pour empêcher une éventuelle action rotatoire des fragments distaux du radius et de l'ulna par le muscle pronateur [3,[10][11][12]. Le chirurgien doit faire attention d'éviter les troubles potentiels de croissance de l'extrémité distale du cubitus, surtout lors de la réduction à ciel ouvert [4,5].…”

“…Le terme équivalent de Galeazzi ne décrit pas la vraie physiopathologie de la lésion. Imatani et al [12] ont proposé le terme de pseudo-Galeazzi par similitude avec les pseudoluxations acromioclaviculaires chez les enfants [13].…”