Galeazzi, Colles, Smith

GALEAZZI FRACTURE-DISLOCATION

DEFINISI an injury pattern involving a radial shaft

fracture with associated dislocation of the distal radioulnar joint (DRUJ); the injury disrupts the forearm axis joint.

Isolated fractures of the junction of the distal third and middle third of the radius with associated subluxation or dislocation of the DRUJ

ETIOLOGI

The etiology of the Galeazzi fracture is thought to be a fall that causes an axial load to be placed on a hyperpronated forearm.

PATOFISIOLOGI

The deforming forces include those of the brachioradialis, pronator quadriceps, and thumb extensors, as well as the weight of the hand. The deforming muscular and soft-tissue injuries that are associated with this fracture cannot be controlled with plaster immobilization.

  Mechanism: Fall on outstretched hand with elbow flexed

PRESENTATION Pain and soft-tissue swelling are present at the

distal-third radial fracture site and at the wrist joint. Forearm trauma may be associated with

compartment syndrome. Anterior interosseous nerve (AIN) palsy may also be

present, but it is often overlooked because there is no sensory component to this finding. Injury to the AIN can cause paralysis of the flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) to the index finger, resulting in loss of the pinch mechanism between the thumb and index finger.

RADIOLOGI Standard anteroposterior (AP) and true lateral

forearm views are obtained, must include of the wrist and the elbow.

Transverse or oblique fracture in the lower third of radius, with angulation or overlap

Inferior radioulnar joint is subluxated or dislocated

A bilateral, axial computed tomography (CT) scan of the forearm is the preferred imaging study for diagnosing DRUJ disruption.

galeazzi

fracture of the radius with angulation

associated dislocation of the distal ulna

COLLES FRACTURE

DEFINISI Transverse fracture of radius just above the

wrist, with dorsal displacement of distal fragment

Common in older people and related to postmenopausal osteoporosis

MECHANISM usually caused by a fall onto an outstretched

hand Bone fracture at the corticocancellous junction

and distal fragment collapse into extension, dorsal displacement, radial tilt and shortening

PRESENTATION ‘Dinner-fork’ deformity, with prominence on

the back of the wrist and depression in front Minimal deformity local tenderness and pain

on wrist movemeent

RADIOLOGI Transverse fracture of radius at the

corticocancellous junction Ulnar styloid process is often broken off Radial fragment is impacted into radial and

backwards tilt Sometimes is severely comminuted or

crushed

Dorsal angulation of fracture fragment

SMITH FRACTURE

DEFINISI Or ‘Reverse Colles’ fracture Tranverse fractur of radius just above the

wrist, with distal fragment displace anteriorly

MECHANISM Fall on the back of the hand Distal fragment displaced volarly Ulnar head can be displaced dorsally

PRESENTATION ‘Garden-Spade’ defformity

RADIOLOGI Fracture through distal radial metaphysis Distal fragment is displaced and tilted

anteriorly

TERIMA KASIH