Choudhury Muntasir Mannan, Saggi Sandip Singh, Chung Sze Ryn, Yap Robert Tze Jin, Chia Dawn Sinn Yii, Jiang Jackson Kian Hong, Chin Andrew Yuan Hui
Department of Orthopaedic Surgery, Sengkang General Hospital, Singapore, Singapore.
Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore, Singapore.
J Wrist Surg. 2023 Nov 22;14(1):27-33. doi: 10.1055/s-0043-1776002. eCollection 2025 Feb.
Galeazzi fracture-dislocations result from severe trauma and can lead to loss of function of the wrist and forearm if not treated appropriately. To avoid such disasters, meticulous surgical management of the injury is necessary. The current literature talks about symptomatic distal radioulnar joint injuries in Galeazzi fracture-dislocations and the various approaches to managing instability. However, unfortunately, there is a dearth of data on the true incidence of injury to the triangular fibrocartilage in the backdrop of the severity of the mechanism of Galeazzi fractures and the damage it may cause as direct inspection of the triangular fibrocartilage complex is not done routinely as a part of management of such cases. We conducted a retrospective review of six consecutive patients with Galeazzi fracture-dislocations. Wrist arthroscopy was performed in these cases, which revealed complex tears of the triangular fibrocartilage complex involving large segments of the ligament and always involving the dorsal periphery. All tears followed the same pattern of disruption of the attachments of two sides of the triangular fibrocartilage complex. We believe our findings will pave the path to further prospective studies in understanding the degree of damage in the triangular fibrocartilage in such devastating injuries and the need for meticulous arthroscopic repair.
盖氏骨折脱位由严重创伤引起,如果治疗不当,可导致腕关节和前臂功能丧失。为避免此类灾难,对该损伤进行细致的手术处理很有必要。当前文献探讨了盖氏骨折脱位中症状性下尺桡关节损伤以及处理不稳定的各种方法。然而,遗憾的是,鉴于盖氏骨折机制的严重性以及三角纤维软骨可能受到的损伤,而在这类病例的常规处理中并不常规直接检查三角纤维软骨复合体,因此关于三角纤维软骨损伤真实发生率的数据匮乏。我们对连续6例盖氏骨折脱位患者进行了回顾性研究。对这些病例进行了腕关节镜检查,结果显示三角纤维软骨复合体存在复杂撕裂,累及韧带的大片区域,且总是累及背侧周边。所有撕裂均遵循三角纤维软骨复合体两侧附着点破坏的相同模式。我们相信我们的研究结果将为进一步的前瞻性研究铺平道路,以了解此类严重损伤中三角纤维软骨的损伤程度以及细致的关节镜修复的必要性。