Galeazzi and essex lopresti injuries

Abstract

Injuries to the forearm can lead to fractures of either or both the radius and ulna as well as dissociation between the bones in the forearm. Galeazzi fractures occur when the current of injury in the forearm fractures the radius shaft and then proceeds through the distal radioulnar joint (DRUJ) to cause dislocation or subluxation of the joint. In children, this can be a true DRUJ dislocation or can also be a fracture-separation of the distal ulnar physis. Anatomic reduction of the fracture typically leads to DRUJ stability unless soft tissues are interposed in the joint or physis. The key to treatment of these complex injuries is an anatomic reduction and the creation of a stable joint whether by closed or open methods. Once fracture healing is identified, therapeutic exercises can be initiated and a gradual return to full activities can be expected. Essex-Lopresti injuries are seen in patients that have interruption of the interosseous membrane and dissociation of the radius and ulna. They have not been described in skeletally immature patients, but clinicians should be aware of the risks of proximal migration of the radius that can occur after radial head resection in these patients.