SAQ 250 – Orthopaedics – Galeazzi fracture and compartment syndrome

Question 3. Galeazzi fracture and compartment syndrome.

a. X-ray findings

• Fracture of the distal two-thirds of the radius.
• Complete displacement, with the distal fragment displaced ulnarly.
• Spiral comminuted fracture pattern.
• Approximately 30 degrees dorsal angulation.
• Distal radioulnar-joint dislocation with posterior radial displacement.

b. Compartment-syndrome findings

• Pain on passive finger or wrist stretch.
• Pain on active finger or wrist movement.
• Swollen or tense compartments.
• Tender compartments.
• Consistent sensory change.
• Consistent weakness.
• Impaired capillary refill or pulse deficit as late findings.
• Raised intracompartmental pressure.

c. Management

• Remove plaster and all external pressure.
• Provide analgesia.
• Elevate the limb appropriately.
• Obtain urgent orthopaedic review for emergency fasciotomy.