A Case of Bilateral Galeazzi Fracture-Dislocations

Abstract

Bilateral Galeazzi fracture-dislocations are extremely rare injuries and only a few case reports have been described so far in the literature. Herein, we report the case of a 31-year-old bicyclist who sustained bilateral Galeazzi fracture-dislocations after a collision with a car. Both radial shaft fractures were simple (AO type 22-A2.3), at the same level (Type I: <7.5 cm from the joint line), and without severe comminution having their apex located dorsally. Internal fixation was accomplished in both fractures with an 8-hole, 3.5-mm locking plate; the stability of the distal radioulnar joint (DRUJ) was assessed with several intraoperative tests and found to be stable so that no additional stabilization was necessary. Postoperatively, the forearms were immobilized in a long forearm cast for four weeks. At the last follow-up evaluation, six years postoperatively, the patient was pain-free, had a full range of motion with a total Mayo wrist score of 95 in both wrists. Bilateral Galeazzi fracture-dislocations are rare injuries requiring proper radial fracture management and thorough assessment of DRUJ stability.

Keywords: bilateral; druj stability; fracture-dislocation; galeazzi; internal fixation.

Figure 1. Preoperative radiographs.

Preoperative anteroposterior (a) and lateral (b) radiographs of both forearms demonstrating bilateral, almost identical, Galeazzi fracture-dislocations. Both radial fractures were simple, located <7.5 cm from the joint.

Figure 2. Postoperative radiographs.

Postoperative anteroposterior (a) and lateral (b) radiographs of both forearms after removal of the splints (at one month). There is a normal union process of the radial shaft fractures and no evidence of DRUJs’ instability. DRUJ: Distal radioulnar joint.

Figure 3. Follow-up radiographs.

Anteroposterior (a) and lateral (b) radiographs of both forearms at six years follow-up. There was a union of the radial fractures and stable DRUJs’ joints without evidence of recurrence or ulna migration. The Mayo wrist score was 95 in both limbs. DRUJ: Distal radioulnar joint.