Vaishya Raju, Shrestha Sundar Kumar, Vaish Abhishek
Department of Orthopaedics, Indraprastha Apollo Hospitals, New Delhi, India.
Chin J Traumatol. 2013;16(6):344-6.
Fracture of either radius or ulna with a dislocation either at the proximal or distal radioulnar joint (DRUJ) is not a common injury and is inherently unstable. Here we report a case series, with both-bone forearm fractures associated with dislocation of DRUJ, as a Galeazzi-variant type fracture-dislocation, and try to analyze this injury pattern.
The study was based on 6 patients having Galeazzi-variant type fracture-dislocation of different age (20 to 45 years). All fractures were closed type. Two fractures involved the same level and three fractures were at different levels of radius and ulna shaft. After thorough examination and investigations they were treated with limited contact dynamic compression plate without additional fixation for DRUJ.
All cases were followed up for 24 weeks. The maximum incidence occurred in age group between 31 and 40 years. All the fractures of both radius and ulna were united in average time of 12 weeks. Range of motion of wrist and elbow, supination and pronation at final follow-up were normal. There was no subsequent re-subluxation or dislocation of the DRUJ in any of the cases.
Galeazzi variant in adult is a new undescribed pattern of forearm with wrist injury. Stable open reduction and internal fixation of both-bone forearm fractures is mandatory, followed by 3 to 4 weeks of immobilization in a cast for the healing of disrupted DRUJ.
桡骨或尺骨骨折伴近端或远端桡尺关节(DRUJ)脱位并非常见损伤,且本质上不稳定。在此,我们报告一组病例,即双前臂骨折伴DRUJ脱位,作为盖氏骨折变异型骨折脱位,并试图分析这种损伤模式。
该研究基于6例不同年龄(20至45岁)的盖氏骨折变异型骨折脱位患者。所有骨折均为闭合性。2例骨折累及同一水平,3例骨折位于桡骨和尺骨骨干的不同水平。经过全面检查和评估后,对他们采用有限接触动力加压钢板治疗,DRUJ无需额外固定。
所有病例均随访24周。最高发病率出现在31至40岁年龄组。桡骨和尺骨的所有骨折平均在12周内愈合。末次随访时腕关节和肘关节的活动范围、旋前和旋后均正常。所有病例中DRUJ均未出现后续再半脱位或脱位。
成人盖氏骨折变异型是一种新的未描述的伴有腕部损伤的前臂损伤模式。双前臂骨折进行稳定的切开复位内固定是必要的,随后用石膏固定3至4周以促进受损DRUJ的愈合。