![]() ![]() Orthopedic pitfalls in the ED: Galeazzi and Monteggia fracture-dislocation. Am J Emerg Med. 2001 19(3):225-8. 1 ORTHO BULLETS Volume OneTrauma2017Collected By : Dr AbdulRahman AbdulNasser Preface O. Treasure Island (FL): StatPearls Publishing 2017 Jun-. Available from: PMID: 29262123 Fracture of the distal radial shaft: mistakes in management. Pediatric equivalent Galeazzi fracture with SH-1 fracture of the distal ulna. Management of complications of forearm fractures. Distal radius fracture with dislocation of the DRUJ. J Am Acad Orthop Surg 2011 19(10): 623-33. A Galeazzi-equivalent fracture is a distal radial fracture with a distal ulnar physeal fracture 2. High (up to 90%) complications rates seen if treated nonoperatively ( Perron 2001, Hughston 1957)Ītesok KI et al.Requires ORIF for acceptable outcome because of loss of stability at DRUJ and pull of forearm muscles causes loss of proper alignment in cast,.If unable to reduce, orthopedic consult in ED.Closed reduction of the radius followed by reduction of the ulna in the DRUJ, with application of long arm splint.Managed conservatively, if non-reducible or unstable may require ORIF.If there is an isolated radius fracture, always examine the distal radioulnar joint (DRUJ) on x-ray. For all Galeazi fracture-dislocations, the arm should be splinted and the nearest orthopaedic on call service should be consulted. Closed reduction of radius fracture and splinting with long arm splint in supination Galeazzi fracture-dislocations are often missed and may be difficult to recognise. Summary Galeazzi fracture-dislocations are often missed and may be difficult to recognise.Managed with ORIF If unable to reduce radial head, orthopedic consult in ED.The foot is usually dislocated medially and superiorly as it is plantarflexed and inverted, usually as. The commonly fractured bones are the calcaneus, cuboid and navicular. talonavicular and calcaneocuboid joints which separate the hindfoot from the midfoot. Priority is closed reduction of the radial head with attention to anatomic alignment of ulna with application of long arm splint Chopart fracture-dislocations occur at the midtarsal (Chopart) joint in the foot, i.e.Usually managed conservatively if successful initial reduction.Inability to reduce radial head: Discuss with orthopedics for prompt consultation in ED vs admission for OR vs transfer to pediatric orthopedic referral center.Ensure anatomic alignment of the ulna and place in supinated long arm splint.Priority is closed reduction of radial head, often made difficult by associated plastic/greenstick deformity. ![]()
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