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Galeazzi Fracture
Cardiovascular Presentations
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Achilles tendon rupture
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Ankle fracture
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Burn
Calcaneus fracture
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Distal radius fracture
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Scalp laceration
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Skull fracture
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Supracondylar pediatric fracture
Tendon laceration (hand:wrist)
Thoracic and lumbar spine fracture
Tibia:fibula fracture
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Traumatic epistaxis
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Acetaminophen toxicity
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High-altitude illness
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Systemic and Miscellaneous Presentations
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Galeazzi Fracture
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Back
Clinical Assessment Checklist
Browse categories and answer follow-up questions to refine your symptom profile.
Approach to the Critical Patient
Immediate threats
Life and limb threats requiring immediate action
▶
Open fracture
▶
Wound communicating with fracture site
Bone visible or protruding
Emergent orthopedic consultation and OR planning
Compartment syndrome
▶
Pain out of proportion to injury
Pain with passive finger extension — most sensitive early sign
Tense swollen forearm compartments
Paresthesias or hypoesthesia in median, ulnar, or radial distributions
Forearm compartment syndrome occurs in approximately 8–15% of diaphyseal forearm fractures
If compartment syndrome confirmed, emergent fasciotomy
Neurovascular compromise
▶
Absent or asymmetric radial or ulnar pulses
Hand pallor, coolness, or cyanosis
Motor deficit in finger or thumb extension (posterior interosseous nerve)
If vascular injury suspected, urgent vascular surgery consultation
Monitoring and stabilization
Initial stabilization targets
▶
Neurovascular checks before and after splinting
▶
Radial and ulnar pulse documentation
Capillary refill at fingertips
Sensory check in all three nerve distributions
Splint application in ED
▶
Sugar-tong or long-arm posterior splint
Forearm positioned in neutral to slight supination
Well-padded to reduce pressure injury risk
Serial compartment checks when high-energy mechanism
▶
Every 1–2 hours minimum in ED observation
Threshold for compartment pressure measurement if clinical concern
Consultation triggers
Orthopedic surgery consultation triggers
▶
All adult Galeazzi fractures require orthopedic consultation in the ED
▶
Near-universal need for operative fixation in adults
80% failure rate with conservative management alone
Emergent consultation required for
▶
Open fracture
Compartment syndrome
Neurovascular compromise
Irreducible DRUJ
Urgent consultation for all closed injuries
▶
ORIF typically planned within 1–2 weeks of injury
Prolonged delay risks DRUJ soft tissue contracture
History
Mechanism and presentation
Mechanism of injury
▶
Fall on outstretched hand (FOOSH)
▶
Wrist extended and forearm pronated at moment of impact
Most common mechanism in all age groups
Direct blow to the dorsal forearm
▶
Dashboard injury in MVC
Contact sports impact
High-energy trauma
▶
Motor vehicle collision
Fall from height
Sports involving falls (cycling, skateboarding, gymnastics)
Symptom pattern
▶
Forearm pain — mid to distal shaft
▶
Dual-site pain at both forearm shaft and wrist is a critical diagnostic clue
Wrist pain or swelling
▶
Often underappreciated by patient who focuses on forearm deformity
Limited forearm rotation
▶
Inability to pronate or supinate
Neurologic symptoms
▶
Numbness or tingling in hand
Weakness of grip or finger extension
Risk factors and context
Patient risk profile
▶
Young adult males — peak incidence
▶
High-energy sporting and occupational mechanisms
Older adults with osteoporosis
▶
Lower-energy mechanisms sufficient for fracture
Higher operative complexity given bone quality
Anticoagulant or antiplatelet use
▶
Increases risk of compartment syndrome from hematoma
Hand dominance
▶
Documents functional impact for operative planning
Prior history
▶
Previous forearm, wrist, or DRUJ injury or surgery
Metabolic bone disease (osteoporosis, Paget's, hyperparathyroidism)
Diabetes — impairs wound healing and infection risk
Smoking history — significantly impairs fracture union
Alarm features
Red flag findings demanding immediate escalation
▶
Open wound overlying fracture site
▶
Assume communication until proven otherwise
Progressive paresthesias or weakness after splinting
▶
Rising compartment pressure or nerve compression
Cold or pulseless hand after splinting
▶
Vascular injury or excessive traction
Increasing pain despite analgesia and elevation
▶
Compartment syndrome until proven otherwise
Physical Exam
Inspection and palpation
Forearm and wrist inspection
▶
Forearm deformity
▶
Angular deformity at mid to distal third of radius
Shortening of the radial column
Ulnar head prominence at the wrist
▶
Dorsal prominence — most common DRUJ dislocation pattern
Volar prominence in less common volar dislocation variant
Swelling and ecchymosis
▶
Extent and distribution
Open wounds assessed for depth and contamination
Palpation findings
▶
Tenderness along the radial shaft (mid to distal third)
▶
Point of maximal tenderness localizes fracture level
DRUJ tenderness and instability
▶
Key finding distinguishing Galeazzi from isolated radial shaft fracture
Piano key sign: ulnar head depresses and springs back
Palpate the entire forearm and elbow
▶
Rule out concomitant Monteggia pattern (proximal ulna tenderness)
Rule out Essex-Lopresti (radial head tenderness)
Neurovascular assessment
Vascular examination
▶
Radial and ulnar pulse quality and symmetry
▶
Compare to contralateral limb
Document before and after any manipulation
Capillary refill in all fingertips
▶
Normal less than 2 seconds
Hand color and temperature
▶
Pallor, mottling, or cyanosis
Neurologic examination
▶
Posterior interosseous nerve (PIN) — most at risk
▶
Thumb extension at IP joint (EPL)
Finger extension at MCP joints
PIN injury reported in up to 20% of surgically treated cases
Median nerve
▶
Sensation palmar thumb, index, and middle fingers
Thumb opposition strength
Ulnar nerve
▶
Sensation small finger and ulnar ring
Finger abduction and adduction (interossei)
Radial sensory nerve
▶
Sensation dorsal first web space
Compartment assessment
Compartment syndrome screening
▶
Forearm compartment palpation
▶
Volar compartment — flexor mass
Dorsal compartment — extensor mass
Tenseness or woody consistency
Pain with passive stretch
▶
Passive finger extension stretches volar compartment
Most reliable early clinical sign
Paresthesias in distal distribution
▶
Numbness in median or ulnar territory
Loss of two-point discrimination
If clinical concern, compartment pressure measurement
▶
Delta pressure (diastolic BP minus compartment pressure) less than 30 mmHg indicates fasciotomy threshold
PITFALLS
Common diagnostic errors
▶
Failure to image the wrist with forearm radiographs
▶
DRUJ disruption missed in up to two-thirds of cases on initial presentation
Only approximately 31% of Galeazzi lesions recognized at first assessment
Overlooking DRUJ tenderness on exam
▶
Forearm fracture pain overshadows wrist findings
Misinterpreting pediatric Galeazzi-equivalent
▶
Physeal separation rather than true DRUJ dislocation in children
Managed conservatively rather than operatively in most pediatric cases
Differential Diagnosis
Forearm fracture-dislocation patterns
Key differentials requiring immediate distinction
▶
Isolated radial shaft fracture (without DRUJ disruption)
▶
ICD-10 S52.309A
Most common misdiagnosis — always assess the DRUJ
Distinguished by intact DRUJ on imaging and exam
Monteggia fracture-dislocation
▶
ICD-10 S52.279A
Proximal ulna fracture plus radial head dislocation
Disruption is at the elbow not the wrist
Essex-Lopresti injury
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Radial head fracture plus interosseous membrane disruption plus DRUJ injury
Involves entire forearm longitudinal axis
Missed DRUJ component leads to chronic instability
Both-bone forearm fracture
▶
ICD-10 S52.409A
Fractures of both radius and ulna
Without isolated DRUJ dislocation pattern
Distal forearm and wrist injuries
Distal radius fractures
▶
Colles fracture
▶
ICD-10 S52.501A
Distal radius fracture with dorsal displacement
No radial shaft fracture component
Smith fracture
▶
Distal radius with volar displacement
Distinct from radial shaft injury
Barton fracture
▶
Distal radius with radiocarpal dislocation
Involves articular surface
Isolated DRUJ dislocation
▶
Without radial shaft fracture
▶
Acute traumatic DRUJ subluxation
Confirmed by absence of radial shaft fracture on imaging
Carpal injuries
▶
Scaphoid fracture — tender in anatomic snuffbox
Lunate or perilunate dislocation — wrist widening on AP view
Laboratory Tests
Preoperative workup
Operative planning labs
▶
Complete blood count
▶
Baseline hemoglobin for surgical planning
Leukocytosis if open fracture and infection concern
Basic metabolic panel
▶
Renal function for perioperative medication dosing
Electrolyte baseline
Coagulation studies (PT/INR, PTT)
▶
Mandatory if anticoagulant use or bleeding history
Guides perioperative anticoagulation reversal planning
Type and screen
▶
Per institutional protocol for anticipated surgical blood loss
Compartment syndrome and open fracture labs
Compartment syndrome evaluation
▶
Serum creatine kinase (CK)
▶
Elevated greater than 669 U/L associated with increased rhabdomyolysis risk
Trended serially if compartment syndrome confirmed
Serum lactate
▶
Elevated in severe compartment syndrome with limb ischemia
Greater than 2 mmol/l suggests systemic perfusion impairment
Urinalysis with microscopy
▶
Myoglobinuria if rhabdomyolysis present
Pigmented casts and red-brown urine
Open fracture labs
▶
Complete blood count
▶
Baseline for antibiotic duration planning
Blood cultures
▶
If systemic infection signs present
Wound swab cultures not recommended as initial management
▶
Does not guide empiric antibiotic selection in acute setting
Point-of-care testing
Bedside assessments
▶
Compartment pressure measurement (Stryker device or arterial line transducer)
▶
Fasciotomy threshold: delta pressure less than 30 mmHg
Absolute threshold: compartment pressure greater than 30 mmHg
Glucose
▶
Relevant in diabetic patients undergoing procedural sedation
Pregnancy test
▶
Females of reproductive age prior to sedation or operative intervention
Diagnostic Tests
Scoring Systems
Rettig and Raskin classification
▶
Type I fracture
▶
Fracture within 7.5 cm of the distal radial articular surface
Higher rate of DRUJ instability approximately 55%
Operative fixation and intraoperative DRUJ assessment mandatory
Type II fracture
▶
Fracture more than 7.5 cm from the articular surface
Lower rate of DRUJ instability approximately 6%
DRUJ still must be assessed intraoperatively after radial fixation
DRUJ instability predictors
▶
Radiographic predictors of DRUJ instability after fixation
▶
Radial shortening greater than 5 mm — moderately predictive
Fracture within 7.5 cm of lunate facet — higher risk
Ulnar styloid fracture — present in approximately 20% of cases, significantly associated with instability (p=0.02)
Gold standard remains intraoperative stress test after radial ORIF
Intraoperative DRUJ stress test
▶
DRUJ stressed in pronation, supination, and neutral after radial fixation
Definitive assessment for instability per Class II evidence
MRI
MRI indications in Galeazzi fracture
▶
Not indicated acutely
▶
Radiographic diagnosis is sufficient for acute management
CT provides better bony detail when needed
Chronic DRUJ instability evaluation
▶
TFCC (triangular fibrocartilage complex) injury characterization
Pre-surgical planning for TFCC repair
Ligamentous injury mapping when DRUJ instability persists after radial union
Occult fracture or cartilage injury
▶
When symptoms persist and plain films are negative
Differentiation of bony versus soft tissue pathology
CT
CT indications in Galeazzi fracture
▶
Rarely needed acutely for diagnosis
▶
Plain radiographs sufficient for most cases
Specific indications
▶
Complex fracture pattern with comminution
DRUJ congruity assessment when plain films equivocal
Preoperative planning for complex periarticular fractures
Suspected occult fracture not seen on plain films
CT findings of DRUJ disruption
▶
Dorsal or volar subluxation of the ulna relative to sigmoid notch
Widened DRUJ space
Ulnar styloid fracture fragment position
CT for complications
▶
Malunion assessment
Hardware failure postoperatively
Delayed union or nonunion evaluation
Ultrasound
Point-of-care ultrasound role
▶
Not primary diagnostic modality for Galeazzi fracture
▶
Radiographs remain standard of care for diagnosis
DRUJ assessment with ultrasound
▶
Dynamic assessment of DRUJ in pronation and supination
Operator-dependent accuracy
Useful when radiation avoidance preferred (pregnancy)
Soft tissue assessment
▶
Hematoma extent at fracture site
Tendon interposition at DRUJ if irreducible
Neurovascular screening
▶
Radial and ulnar artery flow with Doppler
Useful when vascular injury is suspected and angiography is not immediately available
Disposition
Admission indications
Admission criteria
▶
Open fracture
▶
IV antibiotics initiated within 1 hour of presentation
Wound irrigation and debridement within 6–24 hours
Tetanus prophylaxis
Compartment syndrome
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Emergent surgical fasciotomy
ICU-level monitoring post-fasciotomy
Neurovascular compromise
▶
Vascular surgery consultation
Operative exploration if ischemia confirmed
Polytrauma
▶
Trauma surgery activation per mechanism criteria
Galeazzi management integrated into damage control sequence
Urgent operative planning requiring same-day or next-day OR access
▶
DRUJ irreducibility
Significant shortening or displacement
Discharge criteria
Copy
Criteria for ED discharge with outpatient orthopedic follow-up
▶
Closed fracture adequately splinted
▶
Sugar-tong or long-arm posterior splint in neutral to supination
Neurovascular exam intact post-splinting
No signs of compartment syndrome
▶
Reassessed after splint application
Swelling controlled with elevation
Pain controlled with oral analgesics
▶
Ibuprofen 400–600 mg PO every 6–8 hours
Acetaminophen 500–1000 mg PO every 6 hours
Orthopedic follow-up within 48–72 hours confirmed
▶
Earlier if any concern for evolving complications
Patient reliable and able to follow return precautions
Follow-up and transfer
Copy
Follow-up plan
▶
Orthopedic surgery within 48–72 hours for operative planning
▶
ORIF typically planned within 1–2 weeks of injury
Delay beyond 2 weeks risks DRUJ soft tissue contracture
Transfer indications
▶
No orthopedic surgical capability at receiving facility
Open fracture requiring specialist management
Compartment syndrome with surgical delay
Treatment
Acute ED management
Pain management
▶
Multimodal analgesia preferred
▶
Ibuprofen 400–600 mg PO or ketorolac 15–30 mg IV for moderate pain
Acetaminophen 500–1000 mg PO or 1000 mg IV as baseline analgesic
Morphine 0.05–0.1 mg/kg IV titrated for severe pain
▶
Reassess every 15–30 minutes
Caution: avoid doses that mask compartment syndrome symptoms
Regional nerve block adjunct
▶
Hematoma block at fracture site — 5–10 mL 1% lidocaine
Bier block or brachial plexus block if procedural reduction planned
Splinting
▶
Sugar-tong splint for distal radius and DRUJ control
▶
Extends from metacarpal heads to proximal arm
Controls forearm rotation as well as wrist
Long-arm posterior splint alternative
▶
Elbow at 90 degrees
Forearm in neutral to slight supination for DRUJ control
Elevate limb above heart level to reduce swelling
Open fracture management
Wound and antibiotic management
▶
Cefazolin 2 g IV for Gustilo Type I and II open fractures
▶
Initiated within 1 hour of presentation
Class I recommendation based on expert consensus
Gustilo Type III open fractures
▶
Cefazolin 2 g IV plus gentamicin 5 mg/kg IV once daily
Add penicillin G if gross soil contamination (clostridial coverage)
Tetanus prophylaxis
▶
Tetanus toxoid 0.5 mL IM if immunization not current within 5 years
Tetanus immunoglobulin 250 units IM if uncertain vaccination history
Wound care in ED
▶
Gross contamination removal with saline irrigation
Moist dressing applied
Do not close wound in ED
Formal washout in OR
Definitive operative treatment (adults)
Open reduction and internal fixation (ORIF)
▶
Radial shaft fixation
▶
3.5 mm dynamic compression plate via volar Henry approach
▶
Standard of care for adults with greater than 10-degree angulation or displacement
Class I recommendation — 80% failure rate with closed management
Anatomic reduction of radial shaft restores DRUJ alignment in many cases
Intraoperative DRUJ assessment after radial fixation
▶
DRUJ stable — above-elbow cast in supination or neutral for 4–6 weeks
▶
No additional fixation required
DRUJ unstable but reducible — percutaneous K-wire transfixion of DRUJ
▶
K-wire maintained for 4–6 weeks in full supination
DRUJ irreducible — open reduction of DRUJ required
▶
Remove interposed ECU tendon, ulnar styloid fragment, or periosteum
TFCC repair if significant disruption confirmed
Postoperative immobilization
▶
Long-arm splint or cast for 4–6 weeks
▶
Prevents forearm rotation during healing
Progressive range of motion exercises starting at 6 weeks
▶
Hand therapy referral for ROM and grip strengthening
Average grip strength recovery approximately 71% of normal at final follow-up
Conservative treatment (select cases)
Non-operative management
▶
Adults — reserved for rare cases only
▶
Isolated low-energy Galeazzi with minimal displacement
Patient not a surgical candidate (medical comorbidities)
Requires close radiographic surveillance for displacement
Closed reduction and casting in adults
▶
High re-displacement rate — 80% failure
Not recommended as definitive management in most adults
Children and adolescents
▶
Closed reduction and long-arm cast usually successful
▶
True DRUJ dislocation uncommon in children (physeal injury predominates)
Operative fixation reserved for irreducible fractures or older adolescents
Special Populations
Pregnancy
Pregnancy considerations
▶
Imaging approach
▶
AP and lateral forearm radiographs with abdominal shielding
Radiation dose to fetus from extremity radiographs is minimal
CT of the forearm with shielding when plain films equivocal
MRI without gadolinium preferred when soft tissue assessment needed
Analgesia in pregnancy
▶
Acetaminophen 500–1000 mg PO — first-line for all trimesters
NSAIDs — avoid after 20 weeks gestation (premature ductus arteriosus closure risk)
Short-course opioids (morphine) acceptable for severe acute pain with monitoring
Regional nerve block preferred over systemic opioids when feasible
Operative considerations
▶
Surgery generally deferred to postpartum if stable closed fracture
If urgent surgery required, obstetric consultation for fetal monitoring
Regional anesthesia preferred over general anesthesia when possible
DVT prophylaxis
▶
Upper extremity fractures have lower DVT risk than lower extremity
Mobilization and hydration emphasized
Geriatric
Older adult considerations
▶
Mechanism and bone quality
▶
Low-energy falls sufficient due to osteoporosis
Cortical thinning increases complexity of plate fixation
Bone quality assessment relevant to implant selection
Compartment syndrome risk
▶
Reduced compartment compliance with age-related tissue changes
Anticoagulant use common — increases hematoma risk
Medication considerations
▶
NSAIDs — use with caution
▶
Renal impairment risk (CrCl monitoring)
GI bleeding risk — proton pump inhibitor co-prescription
Opioids
▶
Start low, go slow principle
Constipation prophylaxis
Fall risk counseling during opioid use
Operative risk assessment
▶
Frailty scoring for surgical risk stratification
Cardiac and pulmonary comorbidity optimization pre-op
Bone health assessment post-fracture
▶
DEXA scan if not recently performed
Vitamin D and calcium supplementation
Bisphosphonate consideration after fracture healing
Pediatrics
Pediatric Galeazzi and Galeazzi-equivalent fractures
▶
Pediatric anatomy difference
▶
Distal ulna physis is the weak point in children
True DRUJ ligamentous dislocation rare — physeal separation predominates
Galeazzi-equivalent: distal radial fracture with ulnar physeal separation
Treatment approach
▶
Closed reduction and long-arm casting usually successful
▶
Reduction under procedural sedation in ED
Long-arm cast with forearm in supination
Orthopedic follow-up within 1 week to confirm maintained reduction
Operative fixation indications in children
▶
Failed closed reduction
Irreducible physeal injury
Older adolescents with near-adult bone (physeal closure)
Unstable fracture pattern with high re-displacement risk
Analgesia in children
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Ibuprofen 10 mg/kg PO every 6–8 hours (maximum 40 mg/kg/day)
Acetaminophen 15 mg/kg PO every 4–6 hours (maximum 75 mg/kg/day)
Intranasal fentanyl 1.5 mcg/kg for severe pain prior to IV access
Procedural sedation with ketamine 1–2 mg/kg IV or 4–6 mg/kg IM
Child protection
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Mechanism inconsistent with developmental stage warrants safeguarding assessment
Toddler fractures with unclear mechanism require skeletal survey consideration
Background
Epidemiology
Incidence and demographics
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Galeazzi fracture accounts for approximately 7% of forearm fractures
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Less common than Colles fractures but more common than Monteggia
Peak incidence in young adult males
Underdiagnosis is a major clinical problem
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Only approximately 31% of Galeazzi lesions recognized on initial presentation
DRUJ disruption overlooked in up to two-thirds of cases
Epidemiology by mechanism
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Low-energy FOOSH mechanisms predominate in community settings
High-energy MVCs and sports injuries in young adults
Elderly low-energy falls increasingly prevalent with aging population
Historical context
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Described by Ricardo Galeazzi in 1934
Named "fracture of necessity" by Campbell — operative treatment is almost always necessary in adults
Pathophysiology
Injury mechanism
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Combined axial load and rotational force
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Hyperpronation at moment of FOOSH impact
Radial shaft fails in bending — transverse or short oblique pattern
DRUJ disrupts as radial shaft displaces
DRUJ stabilizing structures injured
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Triangular fibrocartilage complex (TFCC) — primary DRUJ stabilizer
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Peripheral TFCC tears allow DRUJ dislocation
Interosseous membrane — longitudinal forearm stability
ECU subsheath — dynamic DRUJ stabilizer
Deforming forces maintaining displacement
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Brachioradialis — proximal radial displacement
Pronator teres and pronator quadratus — forearm pronation deformity
Thumb abductors — radial shortening
DRUJ dislocation direction
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Dorsal dislocation most common (forearm pronated at injury)
Volar dislocation with forearm supinated at injury
Classification system
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Rettig and Raskin classification (treatment-oriented)
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Type I: Fracture within 7.5 cm of articular surface — 55% DRUJ instability rate
Type II: Fracture beyond 7.5 cm — 6% DRUJ instability rate
Therapeutic Considerations
Operative principles
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Radial shaft fixation restores forearm anatomy and allows DRUJ assessment
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Anatomic reduction and rigid fixation of the radius is the primary goal
3.5 mm DCP via volar Henry approach — most reproducible access
DRUJ management algorithm after radial fixation
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Stable DRUJ — cast immobilization sufficient
Unstable reducible DRUJ — K-wire transfixion for 4–6 weeks
Irreducible DRUJ — open reduction mandatory
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Most common interposed structures: ECU tendon, ulnar styloid fragment, periosteum
Immobilization position controversy
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Supination historically preferred — tensions the interosseous membrane reducing DRUJ
Neutral position also acceptable per recent case series evidence
Avoid pronation — destabilizes DRUJ
Outcomes and complications
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Average grip strength recovery approximately 71% of normal
Return to full activity at 3–6 months post-surgery
Potential complications
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Chronic DRUJ instability — most significant long-term complication
Loss of forearm rotation — particularly pronation
Radial malunion — increases DRUJ instability risk
PIN injury — up to 20% of cases
Wrist osteoarthritis — late complication
Patient Discharge Instructions
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Galeazzi fracture home care after splinting
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Keep the splint dry and intact
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Cover with a plastic bag when showering
Do not remove or modify the splint
Elevate the arm above heart level as much as possible
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Especially for the first 48–72 hours to reduce swelling
Use a pillow when lying down
Ice pack over the splint
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20 minutes on, 20 minutes off for the first 24–48 hours
Wrap ice in a cloth to protect skin
Pain management at home
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Ibuprofen 400–600 mg every 6–8 hours with food if tolerated
Acetaminophen 500–1000 mg every 6 hours as needed
Do not exceed recommended doses of either medication
Activity restrictions
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No weight-bearing or loading through the splinted arm
No driving until cleared by your surgeon
Avoid strenuous activity with the injured arm
Wiggle your fingers regularly to maintain circulation
Follow-up instructions
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Orthopedic surgery appointment within 48–72 hours
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Surgery is almost always required for this type of injury
Do not eat or drink after midnight before your appointment in case surgery is planned
Bring all imaging from this visit to your follow-up
Return to emergency department immediately for
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Increasing pain that is not controlled by medication
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This can be a sign of dangerous pressure building in the forearm (compartment syndrome)
Numbness, tingling, or pins and needles in the fingers
Fingers turning white, blue, or cold
Inability to move fingers
Increasing tightness or firmness of the forearm
Swelling that is increasing despite elevation
Fever, foul smell, or fluid draining from a wound (if open fracture)
Splint becomes too tight, too loose, or is damaged
References
Guidelines and key sources
Landmark studies and guidelines
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Atesok KI, Jupiter JB, Weiss AP — Galeazzi Fracture, JAAOS 2011
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Comprehensive review of diagnosis and operative management
Identifies 80% failure rate with conservative management in adults
Moore TM, Klein JP, Patzakis MJ, Harvey JP — Results of Compression-Plating of Closed Galeazzi Fractures, JBJS 1985
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Established ORIF as definitive treatment standard
Rettig ME, Raskin KB — Galeazzi Fracture-Dislocation: A New Treatment-Oriented Classification, J Hand Surg 2001
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Defines Type I and II classification based on fracture distance from articular surface
Links classification to DRUJ instability rates
Tsismenakis T, Tornetta P — Galeazzi Fractures: Is DRUJ Instability Predicted by Current Guidelines?, Injury 2016
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Ulnar styloid fracture significantly associated with DRUJ instability (p=0.02)
Radial shortening and fracture distance are imperfect predictors alone
Supporting evidence
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Eberl R et al — Galeazzi Lesions in Children and Adolescents, Clin Orthop Relat Res 2008
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Pediatric management with closed reduction and casting outcomes
Park MJ et al — Immobilization in Supination Versus Neutral Following Surgical Treatment, J Hand Surg 2012
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Neutral and supination immobilization both acceptable post-operatively
Perron AD et al — Orthopedic Pitfalls in the ED: Galeazzi and Monteggia Fracture-Dislocation, Am J Emerg Med 2001
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Emergency medicine perspective on underdiagnosis and pitfalls
von Keudell AG et al — Diagnosis and Treatment of Acute Extremity Compartment Syndrome, Lancet 2015
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Compartment syndrome diagnostic criteria and management
Coding reference
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ICD-10 S52.379A — Galeazzi fracture of radius, initial encounter for closed fracture
ICD-10 S52.379B — Galeazzi fracture, initial encounter for open fracture
SNOMED CT — Galeazzi fracture-dislocation (disorder)
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Management Protocols
Galeazzi Fracture