![]() The patient landed heavily on outstretched hand whilst running, and had her arm caught under her body. The exact mechanism of injury in this case could not be determined from the history. 1,2 Posterior dislocation of the ulnohumeral joint can occur with a valgus distracting force and pathologic forced external rotation (posterolateral dislocation) or less commonly a varus distracting force (posteromedial dislocation). Typically, type I and type II fractures are caused by axial loading of hypersupinated and hyperpronated forearm, respectively. 1,2 Hence, the fracture is further classified into two subtypes: Type I fracture is characterised by dorsal displacement of the distal fragment of the radius (apex volar) with volar dislocation of the distal ulna and type II fracture by volar displacement of the distal radial fragment (apex dorsal) with dorsal dislocation of the distal ulna. 4,8 Observation of this injury led us to study the relevant mechanism and compare our findings with the ones reported in the literature.įorceful axial loading of the hyperpronated forearm is the most probable mechanism of injury associated with Galeazzi fracture 1,2 however, some authors believe that loading in supination also can cause Galeazzi injury. 4–9 It has been suggested that this combination occurs when the magnitude of the deforming force is high or the position of the upper limb at the time of impact is unique. Galeazzi fracture combined with dislocation of the elbow is rare. ![]() Final radiographs demonstrated stable fixation and an enlocated elbow joint ( Fig. The disabilities of the arm, shoulder and hand score and the American shoulder and elbow surgeons score were 18 and 92, respectively. The range of motion was 0–130° at the elbow, 70° extension and 80° flexion at wrist, 80° of supination and 70° pronation at the forearm ( Fig. The sensation in ulnar nerve distribution was gradually improving. She was able to carry out her normal day-to-day activities. At 10 months, she had no pain or instability of her elbow and wrist. The K-wires were removed from the DRUJ after 8 weeks. The elbow was immobilised in the above elbow plaster slab with the elbow in 90° of flexion for 6 weeks. The flexor compartment muscles were clinically viable and contractile at the time of closure. The fasciotomy wound was primarily closed after two days. There were no other clinical signs of compartment syndrome. Vacuum dressing was applied to the wound. A prophylactic volar fasciotomy of forearm was also performed because of significant swelling of flexor compartment of the forearm at the end of procedure. Distal radioulnar joint was found to be unstable and pinned using two percutaneous 1.6 mm K-wires in supination ( Fig. The stability of the DRUJ was examined under fluoroscopy. After internal fixation the stability of the DRUJ and elbow was examined. The patient underwent open reduction internal fixation of the radial shaft fracture the following day using 3.5 mm six-hole locking compression plate (using standard cortical screws) through a standard volar approach of Henry. Immediate manipulation and reduction of the elbow dislocation was performed in emergency department. (A and B) Posterolateral dislocation of the elbow associated with mildly displaced radial head fracture.
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