Rajeev Aysha, Senevirathna Shanaka, Harrison John
Department of Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK.
J Med Case Rep. 2011 Dec 20;5:589. doi: 10.1186/1752-1947-5-589.
The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions) or both. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. To the best of our knowledge, this has not been previously reported in the English literature.
A 26-year-old Caucasian man presented to our department after a fall from a motorbike. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Post-operative radiographs films were satisfactory. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Our patient was noted to have full elbow and forearm function at three months.
Although the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. This can lead to instability of the elbow joint. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation.
盖氏骨折脱位最初由阿斯特利·库珀爵士于1822年描述，但在1934年以意大利外科医生里卡多·盖氏的名字命名。它是一种被归类为桡骨干骨折并伴有下尺桡关节脱位和前臂轴关节破坏的损伤。相关的下尺桡关节损伤本质上可能纯粹是韧带性的，撕裂三角纤维软骨复合体，或涉及骨组织（即尺骨茎突撕脱）或两者皆有。我们报告此病例是因为罕见地出现了肘关节后脱位合并盖氏骨折脱位的情况。据我们所知，此前英文文献中尚未有过此类报道。
一名26岁的白人男性在骑摩托车摔倒后前来我院就诊。他右前臂闭合性孤立性盖氏骨折脱位，未合并肘部损伤，因此需要对桡骨进行切开复位内固定。术后X线片情况令人满意。然而，在为期五周的随访中发现了同侧肘关节脱位的临床和影像学证据，随后需要对关节进行切开复位并修复侧副韧带。我们的患者在三个月时肘关节和前臂功能完全恢复。
尽管经典的盖氏骨折脱位描述仅涉及下尺桡关节，但创伤力可通过前臂骨间膜传递至肘关节。这可能导致肘关节不稳定。因此，我们建议，对于每一例前臂骨折病例，都应进行临床和影像学评估，以检查肘关节和腕关节是否存在半脱位或脱位。
