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Introduction
Posterior dislocation with Galeazzi fracture dislocation in
ipsilateral limb with sequential impact on the forearm and elbow
is rare entity. Because of its peculiar mechanism of injury and
low incidence, this case is presented.
Key words: Forearm fracture, Posterior Dislocation,
Galeazzi
Case report
A 22-year male attended the Emergency
Department of B P Koirala Institute of Health Sciences after 30
minutes of injury with pain, swelling and deformity of the right
elbow and forearm following fall on the ditch. The injury was
occurred due to fall in the ditch with outstretched hand with
twisting of the forearm while pressing over the ground. Distal
neurovascular status was intact. X-ray revealed posterior
dislocation of the elbow with ipsilateral Galeazzi fracture
dislocation (Fig1). Dislocation of elbow was reduced with
anteriorly directing pressure on the forearm at the same time
giving counter pressure on the humerus. X-ray confirmed the
reduction of the dislocation of the elbow. Open reduction and
internal fixation of the radius with 7 holes Limited
Contact-Dynamic Compression Plate and reduction of the distal
radio-ulnar dislocation with K-wire percutaneously was
performed. A posterior above elbow slab in 90-degree flexion was
given. Elbow mobilization was started after 3 weeks with
Olecranon Condylar Brace protection for forearm for 6 weeks.
After 3 months of follow up patient had almost full painless
range of movement of the elbow as well as the wrist, and gained
supination and pronation movement by 6th months of follow up.
Discussion
Isolated posterior dislocation and isolated
Galeazzi fracture dislocation is common injuries encountered1.
Incidence of elbow dislocations with medial condyle or with
fracture of radial head has been reported 3,4,5. But incidence
of the posterior dislocation of the elbow with ipsilateral
Galeazzi fracture dislocation is low2.
The case is presented because of rarity in
mechanism and incidence of injury. This injury occurred due to
two separate impacts occurring sequentially one after the other
during the same fall. The case had excellent outcome without
neurovascular compromise at adequate follow up.
 
Fig.1. showing pre reduction radiograph of Posterior
dislocation of elbow with Galeazzi fracture dislocation in Right
upper limb
References
1. Rockwood CA, Jr, Beaty JH, Wilkins KE. Fractures
in children, 4th edition. Lippincot Raven Philadelphia - New
York. 3 : 844.
2. Mezzarda A, Gusmeroli F, Tettamanzi M, Prestianni B, Molinari
D. A rare injury of the upper limb:elbow dislocation combined
with Galeazzi fracture dislocation. Ital J Orthop Traumatology
Dec.1991;17(4):567-72.
3. Geissler WB, Freeland AF. Radial head fracture associated
with elbow dislocation. Orthopaedics Jul. 1992; 15 (7): 874-7.
4. Rovinsky D, Ferguson C, Younis A, Otsuka NY. Pediatric elbow
dislocation associated with a Milch type I lateral condyle
fracture of the humerus. J Orthop Trauma Aug. 1999; 13 (6):
458-60.
5. Popovic N, Gillet P, Rodriguez A, Lemaire R. Fracture of the
radial head with associated elbow dislocation: results of
treatment using a floating radial head prosthesis. J Or thop
Trauma Mar-Apr. 2000; 14 (3): 171-7.
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