Institute of Medical Science, University of Toronto, Toronto, Canada.
J Am Acad Orthop Surg. 2011 Oct;19(10):623-33. doi: 10.5435/00124635-201110000-00006.
Galeazzi fracture is a fracture of the radial diaphysis with disruption at the distal radioulnar joint (DRUJ). Typically, the mechanism of injury is forceful axial loading and torsion of the forearm. Diagnosis is established on radiographic evaluation. Underdiagnosis is common because disruption of the ligamentous restraints of the DRUJ may be overlooked. Nonsurgical management with anatomic reduction and immobilization in a long-arm cast has been successful in children. In adults, nonsurgical treatment typically fails because of deforming forces acting on the distal radius and DRUJ. Open reduction and internal fixation is the preferred surgical option. Anatomic reduction and rigid fixation should be followed by intraoperative assessment of the DRUJ. Further intraoperative interventions are based on the reducibility and postreduction stability of the DRUJ. Misdiagnosis or inadequate management of Galeazzi fracture may result in disabling complications, such as DRUJ instability, malunion, limited forearm range of motion, chronic wrist pain, and osteoarthritis.
盖氏骨折是桡骨干的骨折，伴有下尺桡关节 (DRUJ) 脱位。通常，损伤机制是前臂的轴向强力负荷和扭转。通过影像学评估可确诊。由于可能会忽视 DRUJ 韧带约束的破裂，因此漏诊很常见。儿童采用解剖复位和长臂石膏固定的非手术治疗已取得成功。在成年人中，由于作用于桡骨远端和 DRUJ 的变形力，非手术治疗通常会失败。切开复位和内固定是首选的手术方法。解剖复位和牢固固定后，应在术中评估 DRUJ。进一步的术中干预取决于 DRUJ 的可复位性和复位后的稳定性。盖氏骨折的误诊或处理不当可能导致严重并发症，如 DRUJ 不稳定、畸形愈合、前臂活动范围受限、慢性腕痛和骨关节炎。
