Division of Plastic and Reconstructive Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA
Division of Orthopaedic Surgery, Mount Carmel Health System, Columbus, Ohio, USA.
BMJ Case Rep. 2022 Nov 2;15(11):e250484. doi: 10.1136/bcr-2022-250484.
A male in his 70s presented with a chronic malunited comminuted Galeazzi fracture dislocation, including angular malunion, radial shortening (1.3 cm ulnar-plus variance) and distal radioulnar joint (DRUJ) instability secondary to chronic dislocation with mechanical rotation block. A modified, single-stage radius corrective osteotomy with bone grafting technique to overcorrect radius length was employed, restoring normal DRUJ motion and stability by engaging the secondary DRUJ stabilisers without triangular fibrocartilage complex repair. DRUJ stability was restored via radius lengthening, engaging the DRUJ's secondary stabilisers, bypassing the need for complex ligamentous reconstruction. The patient returned to full activity. We recommend our simple yet effective approach to treat chronic, malunited Galeazzi fractures with DRUJ instability.
一位 70 多岁的男性患者出现慢性畸形愈合的粉碎性 Galeazzi 骨折脱位，包括成角畸形愈合、桡骨缩短（尺侧+1.3cm 变异）和下尺桡关节（DRUJ）不稳定，这是由于慢性脱位伴机械旋转阻挡导致的。采用改良的单阶段桡骨矫正截骨术和植骨技术过度矫正桡骨长度，通过与次要 DRUJ 稳定器结合，在不修复三角纤维软骨复合体的情况下恢复正常的 DRUJ 运动和稳定性。通过桡骨延长术恢复 DRUJ 稳定性，与 DRUJ 的次要稳定器结合，避免了复杂的韧带重建的需要。患者恢复了全部活动。我们推荐这种简单而有效的方法来治疗慢性、畸形愈合的 Galeazzi 骨折伴 DRUJ 不稳定。
