·      Whenever one of the two bones of the forearm fractures with considerable shortening (usually through angulation), then something has to happen to “shorten” the other bone

o       The other bone can also fracture

o       The other bone can dislocate

o       Ligaments are torn

·      Galeazzi and Monteggia fractures are both fractures in which there is a fracture with shortening of one of the two bones of the forearm with dislocation of the other bone

·      Galeazzi Fracture

o       Mechanism: Fall on outstretched hand with elbow flexed

o       Fracture of the radius with shortening and dislocation of the distal ulna

o       Dorsal angulation

 

 

Galeazzi fracture consists of a fracture of the radius with angulation and
associated dislocation of the distal ulna

 

 

·      Ulnar plus variance (= radial shortening) of >10 mm implies complete disruption of interosseous membrane means complete instability of radioulnar joint

·      Complications of Galeazzi fracture

o       High incidence of

§                     Nonunion

§                     Delayed union

§                     Malunion (unstable fracture)

o       Limitation of pronation or supination

·      Monteggia Fracture

o       Mechanism: direct blow to the forearm

o       Anterior dislocation of the radial head with a fracture of the ulna, usually angulated dorsally

o       May have associated wrist injury

 

Monteggia fracture consists of a fracture of the ulna (red arrow) with angulation and
associated dislocation of the radial head. A line drawn through the shaft of the radius (blue line)
should always intersect the capitellum, no matter what the position of the arm

 

·      Complications

o       Nonunion

o       Limitation of motion at elbow

o       Nerve abnormalities

·      Reverse Monteggia Fracture

o       Dorsally angulated proximal ulnar fracture and posterior dislocation of radial head