$difference between monteggia and galeazzi fracture$

$difference between monteggia and galeazzi fracture$

On the other hand, DRUJ disruption is often identified in patients with fractures of the middle and proximal thirds of the radius diaphysis. Isolated fractures at the distal one-third of the radius are not always associated with DRUJ dislocation, although the fractured radius shortens and tends to cause subluxation of the DRUJ and dorsal angulation of the radius.

$difference between monteggia and galeazzi fracture$

Instability of the DRUJ may occur due to failure to recognize the injury, failure to reduce the dislocation intraoperatively, nonanatomical radial reduction, or interposed soft tissue that blocks reduction. Mikić 8 supported the idea that rupture of the TFCC is the main cause of the DRUJ redislocation. The same authors demonstrated that shortening of the radius by less than 5 mm did not result in DRUJ disruption, whereas shortening of more than 10 mm was associated with both TFCC and interosseous membrane tears. In a cadaver study, Moore et al 7 showed that the fracture of the radius is preceded by the lesion of the interosseous membrane and triangular fibrocartilage complex (TFCC). Moreover, the junction of the middle and distal one-thirds of the radius is at increased risk of fracture due to unique bone mineral content and cross-sectional geometrical properties of the radius at that level. However, the absence of any attachment of the interosseous membrane in the distal one-third of the radius allows shortening of the latter when fractures occur in this part of the radius. The direction of the interosseous membrane fibers helps to prevent radial shortening. Important structures in the development of Galeazzi fracture-dislocations are the DRUJ, the radius, and the interosseous membrane that runs in oblique fashion from the radius to the ulna and firmly constrains these two forearm bones. According to some authors, axial loading of the maximally supinated forearm can also result in the same type of injury.

$difference between monteggia and galeazzi fracture$

These deforming muscular forces cannot be controlled by conservative treatment with plaster immobilization. The deforming forces include those of the brachioradialis, pronator quadratus, and thumb extensors. It is the result of forceful axial loading of the maximally pronated forearm while the wrist is in extension. Galeazzi fracture-dislocation may occur during a fall and less frequently during motor vehicle accidents, electric shock, or blunt trauma. The term Galeazzi-equivalent lesion was introduced in 1982 to describe a fracture of the distal radius in association with a fracture of the distal pole of the ulna in adults or separation of distal ulnar epiphysis without DRUJ disruption in children. 2 It is also known as reverse Monteggia fracture, Piedmond fracture, or Darrach–Hughston–Milch fracture, while the term “fracture of necessity” is also frequently used to describe this inherently unstable injury that requires surgical treatment to achieve favorable outcomes, particularly in adults. 1 However, this injury has become connected with the name of Ricardo Galeazzi who in 1934 reported his experience with 18 such cases. Misdiagnosis or inappropriate treatment will result in persistent DRUJ instability and wrist pain, as well as decreased grip strength and forearm rotation.Īsley Cooper was the first to describe a distal radial shaft fracture with disruption of the DRUJ in 1824. However, the true incidence remains unknown because Galeazzi lesions are frequently underdiagnosed. DRUJ involvement is the unique feature of this type of injury, which accounts for nearly 7% of all fractures of the forearm in adults and nearly 3% in children. Lykissasįracture of the shaft of the radius complicated by dislocation or subluxation of the distal radioulnar joint (DRUJ) is commonly referred to as Galeazzi fracture-dislocation.

$difference between monteggia and galeazzi fracture$

Difference between monteggia and galeazzi fracture