Arch Hand Microsurg.  2024 Mar;29(1):46-52. 10.12790/ahm.23.0049.

The role of arthroscopic triangular fibrocartilage complex repair in a case of bilateral Galeazzi fracture-dislocation

• Choi S
• Park S
• Lee JK

• KMID: 2553171
• DOI: http://doi.org/10.12790/ahm.23.0049

Abstract

This report presents the case of a 23-year-old man with bilateral distal one-third radial shaft fractures and associated distal radioulnar joint disruption, known as Galeazzi fractures, resulting from a fall from a kickboard. After open reduction and plate internal fixation for both radial shafts, the radioulnar joints remained unstable on both sides. We performed arthroscopic repair of the triangular fibrocartilage complex on the left side and used a short arm splint to immobilize the right side. At the 6-month postoperative follow-up, the patient reported mild stiffness in the left wrist, although both sides showed a full range of motion and distal radioulnar joint stability. In conclusion, when achieving anatomic reduction and stable fixation of the radial shaft in a Galeazzi fracture, favorable results can be achieved without additional surgical treatment, even if the distal radioulnar joint is unstable during surgery.

Keyword

Radius fractures; Wrist joint; Triangular fibrocartilage

Figure

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  Fig. 1. Preoperative anteroposterior (A) and lateral (B) radiographs of the right wrists demonstrating a Galeazzi fracture-dislocation. On the left side, an almost identical injury pattern was present (C, D). Both radial fractures were located 9 to 10 cm proximal from the joint, and the ulnar head was dislocated dorsally.

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  Fig. 2. After fixation of the radius fractures, intraoperative stress tests were performed (A, B). Dorsal subluxation of the ulnar head was found in the full pronation position (A).

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  Fig. 3. On the left side, we performed arthroscopic triangular fibrocartilage complex repair using a bone tunnel. Torn triangular fibrocartilage complex was found (A). We made a bone tunnel (B) and repaired the triangular fibrocartilage complex (C, D).

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  Fig. 4. At a 10-week postoperative follow-up visit, plain anteroposterior (A, C) and lateral (B, D) radiographs presented sound union without distal radioulnar instability.

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  Fig. 5. The range of motion of both wrists at postoperative 10 weeks.

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  Fig. 6. Plain radiographs at a 1-year postoperative follow-up visit show bony union with a reduced distal radioulnar joint. Anteroposterior and lateral views of the right (A, B) and the left (C, D) wrists were shown.

Reference

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