He reported being very satisfied with the result, returned to his previous occupation.įigure 3. The patient was reviewed monthly.Īt 13 months follow-up, the patient has regained full flexion and extension of elbow and wrist a supination deficit with full pronation (75˚/0/90˚) and consolidation of the fracture ( Figure 3). The wrist was immobilized by a splint for 3 weeks, followed by rehabilitations. The DRUJ instability was treated with ligament reconstruction as described by Fulkerson and Watson. After internal fixation the DRUJ was found to be unstable. The patient underwent open reduction internal fixation of the radial shaft malunion fracture using locking compression plate through a standard volar approach of Henry. Neither wrist arthrogram nor MRI was done. After explanations, he accepted the surgery. We then concluded that, after the road traffic accident, our patient has had a posterolateral elbow dislocation associated with Galeazzi fracture. A new X-ray reported the reduction of the elbow, radius malunion and DRUJ dislocation ( Figure 2a and Figure 2b). The distal radio-ulnar joint (DRUJ) stress test and piano key sign were positive. In our examination, we have noted a stiffness of the left elbow (0/30˚/95˚), a limitation of the prono-supination with a forearm fixed in pronation 35˚, stiffness in wrist extension and a posterior protrusion of the ulnar head. The lack of clinical improvement motivated this consultation in our hospital on the. Because the patient did not want surgery for radius, it was decided to manage the fracture conservatively. Closed reduction of the dislocated elbow joint was immediately performed under sedation. The clinical and radiological assessment has concluded a posterolateral elbow dislocation associated with fracture of the left radius with no other lesions or neurovascular ( Figure 1). After road traffic accident (falling from a bike), He has been admitted in a district hospital (level 2 hospital) on. He was right-handed, with no known medical history. We have received in consultation a 42 years old male, for a mobility deficit of left elbow and wrist. We have discussed the therapeutic possibilities as well as the functional outcome of the forearm. The treatment of the Galeazzi fracture was made 56 days post traumatic. The particularity of this case was his neglected aspect. We reported another Galeazzi fracture associated with posterolateral dislocation of the elbow. Their management and good result have been reported. The mechanism causing both elbow dislocation and fracture of Galeazzi has been reported. Only seven cases have been reported in the literature. The combination of elbow dislocation and Galeazzi fracture is a rare pattern of injury. Radius fracture associated with radio-ulnar joint dislocation is known as Galeazzi fracture. The elbow dislocations can be isolated or associated with fractures around the elbow.
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