Galeazzi and Monteggia Fracture-Dislocations

· Whenever one of the two bones of the forearm fractures with considerable shortening (usually through angulation), then something has to happen to “shorten” the other bone
o The other bone can also fracture
o The other bone can dislocate
o Ligaments are torn
· Galeazzi and Monteggia fractures are both fractures in which there is a fracture with shortening of one of the two bones of the forearm with dislocation of the other bone
·  Galeazzi Fracture (Photo)
o Mechanism: Fall on outstretched hand with elbow flexed
o Fracture of the radius with shortening and dislocation of the distal ulna 
o Dorsal angulation
· Ulnar plus variance (= radial shortening) of >10 mm implies complete disruption of interosseous membrane means complete instability of radioulnar joint
· Complications of Galeazzi fracture
o High incidence of 
§ Nonunion
§ Delayed union
§ Malunion (unstable fracture)
o Limitation of pronation or supination
· Monteggia Fracture (Photo)
o Mechanism: direct blow to the forearm
o Anterior dislocation of the radial head with a fracture of the ulna, usually angulated dorsally
o May have associated wrist injury
· Complications
o Nonunion
o Limitation of motion at elbow
o Nerve abnormalities
· Reverse Monteggia Fracture
o Dorsally angulated proximal ulnar fracture and posterior dislocation of radial head

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