## Galeazzi Fracture — Site of Radial Shaft Fracture **Key Point:** A Galeazzi fracture is a fracture of the radial shaft with dislocation of the distal radioulnar joint (DRUJ). The most common site of the radial fracture is the distal third of the radius. ### Anatomical Distribution | Fracture Site | Frequency | Characteristics | |---|---|---| | **Distal third** | 60–70% (most common) | Fracture typically 5–8 cm proximal to wrist; DRUJ dislocation is dorsal | | Middle third | 20–25% | Less common; may have variable DRUJ involvement | | Proximal third | 5–10% | Rare; usually associated with other injuries | | Radial neck | <1% | Extremely rare in Galeazzi pattern | ### Why the Distal Third? 1. **Mechanism:** Galeazzi fractures typically result from FOOSH with the wrist extended and the forearm pronated 2. **Force distribution:** The impact force is transmitted distally along the radius, creating a fracture in the distal metaphysis or distal third 3. **DRUJ anatomy:** The distal radioulnar joint is located at the wrist level; a distal radial fracture naturally disrupts the DRUJ articulation 4. **Interosseous membrane:** The distal third fracture disrupts the distal attachment of the interosseous membrane, destabilizing the DRUJ **High-Yield:** The "Galeazzi rule of thirds" — if you see a distal radial fracture, always check for DRUJ dislocation; if you see DRUJ dislocation, always look for a distal radial fracture. ### Clinical Presentation **Clinical Pearl:** Patients often present with: - Swelling and deformity at the wrist - Prominence of the ulnar head (dorsal DRUJ dislocation) - Loss of pronation/supination - The radial fracture may be missed if DRUJ dislocation is not actively sought on imaging ### Mnemonic **"GALEAZZI = Distal Radial fracture + DRUJ Dislocation"** — the distal location is inherent to the definition. [cite:Rockwood & Green's Fractures in Adults Ch 33]
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