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INTRODUCTION

1. Didefinisikan sebagai fraktur radius dengan dislokasi sendi radio-ulna distal.12. Merupakan fraktur yang jarang dengan kejadian sekitar 1 dari 14 fraktur lengan bawah.13. Terjadi pada jatuh dengan tangan yang terentang dimana lengan bawah mengalami pronasi

secara paksa.1

4. Cara berguna untuk mengingat fraktur tipe ini adalah dengan akronim GFR Galeazzi Fracture

Radius.1

CLINIC

1. Pasien akan mengeluh nyeri dan enggan menggerakkan lengan bawah atau pergelangantangan.

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2. Deformitas yang nyata pada lokasi fraktur radius dapat terlihat.13. Nyeri tekan dengan atau tanpa krepitasi sepanjang radius distal dapat ditemukan.14. Pada pembandingan dengan sisi yang berlawanan, caput ulnaris akan menonjol dengan

pembengkakan jaringan lunak.1

5. Prominence or tenderness over the lower end of ulna is the striking feature.2RADIOLOGY

1. Dapatkan proyeksi AP dan lateral dari lengan bawah termasuk pergelangan tangan.12. Fraktur pada radius umumnya terjadi pada perbatasan 1/3 tengah 1/3 distal.13. Nilai sendi radio-ulna distal akan adanya pelebaran.14. Pada proyeksi lateral, caput ulna biasanya terdorong ke dorsal.15. Seringkali terdapat angulasi ke dorsal pada fraktur radius.16.

Fraktur processus styloideus ulna merupakan hal yang umum dan merupakan pertanda adanyadisrupsi sendi radio-ulna distal.

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7. A transverse or short oblique fracture is seen in the lower third of the radius, with angulation oroverlap. The distal radio-ulnar joint is subluxated or dislocated.

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TREATMENT

1. The important step is to restore the length of the fractured bone. In children, closed reduction isoften successful; in adults, reduction is best achieved by open operation and compression

plating of the radius. An x-ray is taken to ensure that the distal radio-ulnar joint is reduced.

There are three possibilities:2

a. The distal radio-ulnar joint is reduced and stable; no further action is needed, the arm isrested for a few days, then gentle active movements are encouraged. The radio-ulnar joint

should be checked, both clnically and radiologically, during the next 6 weeks.

b. The distal radio-ulnar joint is reduced but unstable; the forearm should be immobilized inthe position of stability (usually supination), supplemented if required by a transverse K-

wire. The forearm is splinted in an above-elbow cast for 8 weeks. If there is a large ulnar

styloid fragment, it should be reduced and fixed.

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c. The distal radio-ulnar joint is irreducible; this is unusual. Open reduction is needed toremove the interposed soft tissues. The triangular fibrocartilage complex (TFCC) and dorsal

capsule are then carefully repaired and the forearm immobilized in the position of stability

for 6 weeks.

2. The gold standard of conservative treatment in children is above elbow casting in supination.33. Conservative treatment of Galeazzi fractures has been shown to lead to unsatisfactory results of

as much as 92% in adults. In contrast, the final results of conservative treatment are generally

good in children (41 cases; age from 3 to 15 yrs old) (Table1 and Table2).4

4. In general, fractures within the distal third were associated with worse outcome, because ofpoorer recognition of the joint injury, a higher incidence of below-elbow immobilization, and

possibly because there was more initial disruption .4

Result Number Level of Fracture Treatment

Distal Third Junction of

Distal and

Middle Third

Below-

Elbow

Plester

Above-

Elbow

Plester

Internal

Fixation

Excellent 25 10 15 7 17 1

Fair 13 8 5 6 6 1

Poor 3 3 - 3 - -

Total 41 21 20 16 23 2

Table1 : An excellent result had satisfactory union with near-perfect alignment and length, no

subluxation, no limitation of function at the elbow or wrist and no limitation of supinating or pronation.

A fair result showed one or more of the following; delayed union, obvious subluxation of the ulnar head,

limitation of pronation or supination of up to 450or other restriction of movement at elbow or wrist. A

poor result was one with one or more of the following: patient dissatisfaction, pain, obvious deformity

of the forearm, non-union, significant shortening of the radius, limitation of pronation or supination of

more than 450or excessive restriction of elbow and wrist function.

Result Supination Neutral Pronation

Excellent 6 7 4

Fair - 3 3

Poor - - -

Table2 : Results in 23 cases treated with above-elbow plester related to the position of rotation of the

forearm

REFERENCES

1. Soetikno RD. Radiologi Emergensi. Bandung: Refika Aditama; 2011.2. Solomon L, et al. Apleys System Orthopaedicsand Fractures 9thed. United Kingdom: Hodder

Arnold . 2010.

3. Rodriguez-Merchan EC. Pedriatic Fractures of the Forearm. Clin Orthop Relat Res. 2005;432:65-72

4. Walsh HP, et al. Galeazzi Fractures in Children. J Bone Joint Surg Br. 1987;69:730-733