What is the recommended management for Galeazzi fracture?

What is the recommended management for Galeazzi fracture?

• A. External fixator
• B. Casting
• C. Open reduction and internal fixation (ORIF)
• D. Hemiarthroplasty

Answer: (C)

Galeazzi fractures are fractures of the distal radius with dislocation of the distal radioulnar joint, so the main issue is restoring and maintaining the alignment of both the radius and the DRUJ. Immobilizing in a cast cannot reliably reduce and hold the DRUJ in place because the injury inherently destabilizes the radius–DRUJ relationship. The best approach is open reduction and internal fixation of the distal radius, usually with a plate, to anatomically restore length and alignment. Once the radius is realigned and stabilized, the DRUJ can settle back into a stable position; the joint is then more likely to remain congruent during healing, and early controlled motion can be started sooner. If instability persists after fixing the radius, additional stabilization of the DRUJ may be considered, but the definitive step is fixing the radius itself. External fixation is reserved for specific scenarios with soft-tissue compromise or when ORIF isn’t feasible, and casting alone tends to fail due to the persistent DRUJ dislocation. Hemiarthroplasty isn’t a treatment for this injury.

Galeazzi fractures are fractures of the distal radius with dislocation of the distal radioulnar joint, so the main issue is restoring and maintaining the alignment of both the radius and the DRUJ. Immobilizing in a cast cannot reliably reduce and hold the DRUJ in place because the injury inherently destabilizes the radius–DRUJ relationship. The best approach is open reduction and internal fixation of the distal radius, usually with a plate, to anatomically restore length and alignment. Once the radius is realigned and stabilized, the DRUJ can settle back into a stable position; the joint is then more likely to remain congruent during healing, and early controlled motion can be started sooner. If instability persists after fixing the radius, additional stabilization of the DRUJ may be considered, but the definitive step is fixing the radius itself. External fixation is reserved for specific scenarios with soft-tissue compromise or when ORIF isn’t feasible, and casting alone tends to fail due to the persistent DRUJ dislocation. Hemiarthroplasty isn’t a treatment for this injury.