Fractures of Both Forearm Bones: Galeazzi Fracture and Monteggia Injury

Surgical Treatment Approaches for Galeazzi Fracture

Galeazzi fractures, characterized by a fracture of the distal radial shaft with disruption of the distal radioulnar joint (DRUJ), require precise surgical intervention to restore function and stability.

Understanding Galeazzi Fracture

A Galeazzi fracture typically results from high-energy trauma, such as a fall on an outstretched hand. This injury disrupts the DRUJ, making surgical fixation necessary.

Indications for Surgical Treatment

• Significant displacement of the radial shaft fracture
• Instability of the distal radioulnar joint
• Failure of closed reduction techniques

Surgical Techniques

Open reduction and internal fixation (ORIF) is the preferred approach for Galeazzi fractures. The following steps outline the surgical procedure:

Step 1: Preoperative Planning

A thorough assessment using X-rays and CT scans helps determine fracture displacement and DRUJ instability.

Step 2: Surgical Exposure

An incision is made along the volar aspect of the forearm to expose the fracture site.

Step 3: Fixation of the Radial Shaft

A plate fixation technique is used to stabilize the fractured radius, ensuring anatomical alignment.

Step 4: DRUJ Assessment and Stabilization

The stability of the DRUJ is evaluated post-fixation. If instability persists, Kirschner wires or a screw fixation may be employed.

Step 5: Postoperative Care

• Immobilization in a splint or cast
• Early rehabilitation to restore wrist and forearm mobility
• Regular follow-up to monitor healing progress

Complications

Potential complications include nonunion, DRUJ instability, and post-traumatic arthritis. Early intervention and proper surgical technique help mitigate these risks.

Conclusion

Surgical management of Galeazzi fractures aims to restore forearm function, ensuring stable DRUJ alignment. Early diagnosis and appropriate intervention lead to favorable outcomes.