Imaging Case of the Week 110

These x-rays are from a 28 year old who has presented with forearm pain and deformity following a fall on his outstretched right hand. What can be seen?


Right forearm and wrist AP

Right forearm and wrist lateral


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The x-rays show a Galeazzi fracture dislocation; there is a fracture of the radial shaft at the junction of the mid- and lower-third, with dislocation of the distal radioulnar joint.

Galeazzi fracture

The patient underwent operative reduction of the DRUJ dislocation and internal fixation of the radial shaft fracture.

Galeazzi fractures account for 3-7% of forearm fractures in adults; the mechanism is a fall on the outstretched hand with the forearm in pronation.

This fracture may be associated with anterior interosseous nerve (AIN) injury and compartment syndrome. AIN is a division of the median nerve and is a pure motor nerve. Injury causes loss of pinch grip between the thumb and index finger (weakness of flexor pollicis longus and flexor digitorum profundus to the index finger).

Galeazzi fracture in adults is an unstable fracture and needs operative intervention.