Clinical Example: Ulnar shortening osteotomy for Galeazzi fracture malunion

The Galeazzi fracture dislocation pattern involves a displaced fracture of the distal radius shaft and distal radial ulnar joint dislocation. Anatomic reduction is critical. This case demonstrates salvage of a Galeazzi fracture dislocation which had inadequate reduction at the time of primary treatment.

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Initial films show a displaced radial shaft fracture and distal dislocation of the distal radial ulnar joint.
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The patient was treated elsewhere with open reduction and internal fixation, but had inadequate restoration of radial length. The patient was troubled by stiffness and pain from distal radioulnar joint incongruity and ulnocarpal abutment syndrome.
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Ulnar shortening osteotomy with compression plate fixation restored satisfactory alignment.  The patient had exuberant periosteal bone growth around the side of osteotomy, but did not have evidence of delayed healing, other hardware problems, and had an excellent clinical result in terms of pain relief and recovery of motion.
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Galeazzi fracture
ulnar shortening osteotomy
ulnar impaction syndrome
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