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CASE REPORT

Posterior dislocation of the elbow with Galeazzi fracture dislocation

Nepal P *, Bajracharya S**, Singh G K***

* Senior Resident
**Junior Resident
***Professor and Head of Department

Address for Correspondence:
Dr Nepal P.
Department of Orthopaedics,
B P Koirala Institute of Health Sciences, Dharan, Nepal
Email: pravinnnp@yahoo.com
 

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.

 

 This is a peer reviewed paper 

Please cite as : Nepal P: Posterior dislocation of the elbow with Galeazzi fracture dislocation

J.Orthopaedics 2005;2(5)e6

URL:
http://www.jortho.org/2005/2/5/e6

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