It is reasonable to perform the PA wrist projection first- this is the easiest view and, if viewed immediately, will provide a diagnosis. If you consider the radius and ulna to form a ring of bone, the ring has been disrupted in two places and is therefore unstable. Patients with Galeazzi fractures will be in considerable pain, even following the administration of pain relief. The distal ulna is demonstrated to have a dorsal dislocation at the DRUJ. There is a small avulsion fracture (arrowed).The artifact along the ulnar aspect of the forearm is from an immobolisation device. There is a displaced fracture of the distal third of the radius and dislocation of the distal radio-ulnar joint (DRUJ) typical of a Galeazzi fracture-dislocation. This 40 year old male presented to the Emergency Department following a fall onto an outstretched hand. It was considered that a dedicated wrist view was warranted. The avulsed fragment is sourced from the ulnar styloid. The radiographer noted the scaphoid fracture (white arrow) and another bony fragment between the distal radius and ulna (black arrow). The appearance is typical of a Galeazzi fracture-dislocation. The displacement of the radial fracture and the dislocation of the ulna at the distal radio-ulnar joint (DRUJ) are better demonstrated in this view. There is also an abnormal positive ulnar variance of the wrist. There is a displaced oblique fracture of the mid/distal 1/3 of the radius. It was clear that the patient had sustained a bony injury. The swelling from the radial fracture was evident, as was the prominence of the ulnar styloid and the radial deviation. This patient presented following a fall from his pushbike. Such fractures have since become synonymous with his name. In 1934, he reported on his experience with 18 fractures with the above-described pattern as a compliment to the Monteggia lesion. Ricardo Galeazzi (1866-1952), an Italian surgeon at the Instituto de Rachitici in Milan, was known for his extensive work experience on congenital dislocation of the hip. The Galeazzi fracture injury pattern was first described 1842, by Cooper, 92 years before Galeazzi reported his results. This is referred to as a Monteggia fracture. The proximal radial line should always pass through the centre of the capitellum The proximal radius does not align with the capitellum There is a fracture of the midshaft of the left ulna with 20 degrees of angular displacement. She was examined and referred for left forearm radiography. This 7 year old girl presented to the Emergency Department after falling onto her left arm. An awareness of these injuries can assist the radiographer to demonstrate them adequately. The Monteggia fracture-dislocation features a dislocation of the radius at the elbow and the Galeazzi fracture-dislocation involves a dislocation of the ulna at the wrist. The Monteggia and Galeazzi are unstable fracture-dislocations of the forearm.
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