O2325 FOREARM FRACTURES COMPLICATED WITH DISTAL RADIO-ULNAR DISLOCATION (GALEAZZI – TYPE LESION)

Abstract

Aims: In the present study we reviewed 105 patients who had had Galeazzi fractures with particular emphasis on classiþcation (þve types according to the fracture patterns), treatment, and þnal results. Methods: One hundred and þve cases (75 males and 30 females) were included in this study. Most of the fractures (70 cases) occurred in the distal third of radial shaft (Type I). Seventeen fractures were in the middle third (Type II), and 11 fractures were in the proximal third of the shaft of the radius (Type III). In four cases disruption of the distal radio-ulnar joint associated with fractures of both bones (Type IV). Finally three cases considered as Galeazzi-equivalent lesions (Type V). Results: The mean follow-up time was 7 years. The overall results were good in 81% of the patients, fair in 14% and poor in the 5% of the patients. Union achieved in 102 cases and non union in three cases (two had had primary conservative treatment and one case was treated surgically). Supination ranged from 40 to 90 degrees (average 77.5 degrees), and pronation from 50 to 90 degrees (average 81.6 degrees). Conclusions: The Galeazzi fracture is uncommon injury with an incidence varying from 3% to 6% of all forearm fractures. The key to satisfactory results in the treatment of the Galeazzi lesion is anatomic restoration of the length of the radius, with application of rigid internal þxation to maintain the reduction. Although most of the reports do not recommend exposing the distal radioulnar joint, we suggest that once the anatomic reduction is secured, anteroposterior and true lateral x-rays planes to control the distal radioulnar joint.