Question
A 30 year old woman falls from a bicycle onto her outstretched hand. She has a deformed forearm and ulnar sided wrist pain.
- Describe the injury.
- How is it managed?
- How is the distal radioulnar joint assessed and treated after fixation?
Answer
Diagnosis
- Galeazzi fracture dislocation, a distal third radial shaft fracture with DRUJ disruption
- DRUJ injury is suggested by an ulnar styloid base fracture, a widened DRUJ and radial shortening over 5 mm
- Fractures within 7.5 cm of the radial articular surface carry a higher risk of DRUJ instability
Management
- ORIF of the radius through a volar Henry approach with a compression plate
- Restoring radial length and bow reduces the DRUJ in most cases
DRUJ after fixation
- Test stability in pronation, neutral and supination
- Stable, early motion
- Reducible but unstable, immobilise in supination or pin the ulna to the radius, and repair the TFCC or fix a large styloid fragment
- Irreducible, open reduction to remove interposed soft tissue such as ECU
Related pages
Author Contributions
Orthofracs team
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.