Simultaneous Galeazzi Fracture and Lunate Dislocation

Leon Z. Liu; Ashley N. McGill; Josef M. Maselli; Garrett P. Wagner; Mohammadali M. Shoja; Gary B. Schwartz

doi:10.1055/a-2702-0345

Journal of Wrist Surgery, Table of Contents

J Wrist Surg
DOI: 10.1055/a-2702-0345

Case Report

Simultaneous Galeazzi Fracture and Lunate Dislocation

Authors

Leon Z. Liu

¹Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Nova Southeastern University, Fort Lauderdale, Florida, United States
Ashley N. McGill

¹Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Nova Southeastern University, Fort Lauderdale, Florida, United States
Josef M. Maselli

¹Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Nova Southeastern University, Fort Lauderdale, Florida, United States
Garrett P. Wagner

¹Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Nova Southeastern University, Fort Lauderdale, Florida, United States
Mohammadali M. Shoja

¹Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Nova Southeastern University, Fort Lauderdale, Florida, United States
Gary B. Schwartz

¹Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD), Nova Southeastern University, Fort Lauderdale, Florida, United States

Abstract

Background

While distal radius fractures are frequently associated with carpal injuries, such associations are rarely observed in Galeazzi fractures.

Case Description

We report a patient who sustained a Galeazzi fracture– dislocation accompanied by a volar lunate dislocation following a high-speed motorcycle collision. Surgical management included open reduction and internal fixation of the lunate and radius, volar radiocarpal ligament repair, and median nerve decompression. Postoperative recovery was excellent, with restoration of full hand function.

Literature Review

To the best of our knowledge, the combination of a Galeazzi fracture–dislocation and a lunate dislocation occurring from a single traumatic event has not been previously documented in the literature.

Clinical Relevance

We propose a double-hit injury mechanism to explain the observed co-occurrence. The initial wrist hyperextension with ulnar deviation and intracarpal supination causing lunate dislocation followed by axial loading and violent hyperpronation producing radial shaft fracture and distal radioulnar joint dislocation. This case illustrates that high-energy trauma may synchronize distinct injury patterns to produce complex upper limb injuries.

Keywords

Galeazzi fracture - lunate dislocation - distal radioulnar joint

Full Text

References

References
1 Mikić ZD. Galeazzi fracture-dislocations. J Bone Joint Surg Am 1975; 57 (08) 1071-1080
2 Morrissy RT, Nalebuff EA. Dislocation of the distal radioulnar joint: anatomy and clues to prompt diagnosis. Clin Orthop Relat Res 1979; (144) 154-158
3 Fowler TP. Intercarpal ligament injuries associated with distal radius fractures. J Am Acad Orthop Surg 2019; 27 (20) e893-e901
4 Heo YM, Kim SB, Yi JW. et al. Evaluation of associated carpal bone fractures in distal radial fractures. Clin Orthop Surg 2013; 5 (02) 98-104
5 Komura S, Yokoi T, Nonomura H, Tanahashi H, Satake T, Watanabe N. Incidence and characteristics of carpal fractures occurring concurrently with distal radius fractures. J Hand Surg Am 2012; 37 (03) 469-476
6 Ossowski D, Thomsen NOB, Clementson M, Besjakov J, Jörgsholm P, Björkman A. Long-term outcomes after capitate fractures: a median 16-year follow-up. Arch Orthop Trauma Surg 2024; 144 (08) 3885-3893
7 Stahl S, Freiman S. Simultaneous scaphoid and Galeazzi fractures. Hand Surg 1999; 4 (02) 185-188
8 Mayfield JK. Mechanism of carpal injuries. Clin Orthop Relat Res 1980; (149) 45-54
9 Mayfield JK. Patterns of injury to carpal ligaments. A spectrum. Clin Orthop Relat Res 1984; (187) 36-42
10 Garcia-Elias M. Carpal instabilities and dislocations. In: Green DP, Hotchkiss RN, Pederson WC. eds. Green's Operative Hand Surgery. Vol 1. 4th ed.. Philadelphia: Churchill Livingstone; 1999: 865-928
11 Weber ER. Biomechanical implications of scaphoid waist fractures. Clin Orthop Relat Res 1980; (149) 83-89
12 Speed K. A Text-Book of Fractures and Dislocations: Covering Their Pathology, Diagnosis and Treatment. 2nd ed.. Philadelphia: Lea & Febiger; 1921
13 Hyman G, Martin FRR. Dislocation of the inferior radio-ulnar joint as a complication of fracture of the radius. J Br Surg 1940; 27 (107) 481-491
14 Evans EM. Pronation injuries of the forearm, with special reference to the anterior Monteggia fracture. J Bone Joint Surg Br 1949; 31B (04) 578-588 , illust