![]() ![]() Injuries are common, both in adults and children, but the fracture patterns in children tend to be different to the adult population due to the nature of the developing bones.Īn ability to interpret elbow radiographs is important to detect what may often be subtle injuries. It is important for the emergency physician to have a good knowledge of the elbow joint and to be aware of the common injuries that occur. Atesok KI, et al.Elbow injuries are common and acute elbow trauma accounts for 2-3% of all visits to the emergency department 6. Galeazzi fracture-dislocation – The Royal Children’s Hospital Melbourneģ. A historical report on Riccardo Galeazzi and the management of galeazzi fractures. 9 – Closed reduction of radial fracture and stabilization of DRUJġ. Poor ligamental strength : Repair associated soft tissue damage during ORIF ( Fig. 4 ) : Requires open reduction and internal fixation (ORIF) to ensure anatomical reduction and stable fixationĢ. High chance of deformity of DRUJ due to greater weight of hand, higher deforming muscle spasm due to brachioradialis and pronator quadratus ( Fig. – General management principles of adults :ġ. Better ligamentous strength : Immobilization of above-elbow cast for 4-6 weeks are sufficient to immobilise forearm to allow stable DRUJ for healing of TFCC Have little soft tissue interposition : Non-surgical closed reduction under GA and fluoroscopic guidance is sufficient for radial fractureĢ. – General management principles for children :ġ. – AP and lateral plain radiograph confirms the diagnosis, DRUJ evaluation is essential to determine the type of Galeazzi fracture ( e.g. Supination/pronation and wrist motion are painful due to disruption of DRUJ Swelling nd tenderness of distal forearm due to distal radial fractureĢ. Depending on the severity, there may have remarkable deformation and angulation of radiusģ. 7 – Classification of Galeazzi fractureġ. – Since most people fall on outstretched pronated hand, so dorsal Galeazzi fracture predominates Fig. Dorsal : Dorsal displacement of ulna, associated with pronation 7 )ġ. Volar : Volar displacement of ulna, associated with supinationĢ. – Classification of Galeazzi fracture : Depends on direction of dislocation of ulna ( Fig. Fracture of distal growth plate of ulna, without disruption of DRUJ Fig. – Galeazzi-equivalent lesion : Variant of classic Galeazzi fracture in skeletally immature children and adolescents ( Fig. Dislocation of distal radio-ulnar joint (DRUJ) – Classic Galeazzi fracture : Unstable fracture-dislocation of forearm result inĢ. Pronation : Proximal end of disal radial fragment can only goes anteriorly as blocked by ulna posteriorly, so there is posterior displacement of distal radial head and dorsal dislocation of ulnaĭefinition and classification of Galeazzi fracture ![]() ![]() Supination : Anterior displacement of distal radial head and thus volar dislocation of ulnaĢ. – Depending on wrist’s position, the distal radial fragment rotates in opposite direction ( Fig. – Forceful axial loading on radius ( most commonly due to fall ) result in fracture of radius and radial shortening Brachioradialis : Pulls the distal radial fragment proximally Fig. Pronator quadratus : Rotational force on distal radiusĢ. – Muscles spasm following fracture contribute to further deformity and compromised closed reduction ( Fig. – Substantial shortening in fractured radius relative to ulna results in marked disruption of TFCC and therefore dislocation of DRUJ 3 – Triangular fibrocartilage complex (TFCC) Deep limb attaches to fovea of ulna and superficial limb attaches to styloid process of ulna Fig. Both deep and superficial limb attaches to junction of lunate fossa and sigmoid fossa of radiusĢ. – DRUJ is primarily stabilized by triangular fibrocartilage complex (TFCC) ( Fig. – Biomechanically, fractures of middle to distal third of radius more likely cause disruption of distal radioulnar joint instead of proximal radioulnar joint – Junction of distal and middle 1/3 of radius is thinnest and thus most prone to fracture ( Fig. – He presented such fracture pattern in largest number of case series with detailed description of management and pathomechanics behind, thus named after him 1 ), a very distinguished orthopedic surgeon in Italy ![]()
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