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