A 25-year-old falls from a bicycle and sustains an isolated fracture of the radial shaft (Monteggia variant). The ulnar bow is intact. X-ray shows a fracture at the junction of middle and distal thirds of the radius with dorsal angulation. There is no associated ulnar fracture. What is the CORRECT eponymous description and management?

• A Monteggia fracture-dislocation; closed reduction and long arm cast
• B Essex-Lopresti injury; ORIF of radius and repair of interosseous membrane
• C Colles fracture equivalent; closed reduction and below-elbow cast
• D Galeazzi fracture; ORIF of radius with open reduction of distal radioulnar joint (DRUJ) ✓

Explanation

A fracture of the distal third of the radius with disruption of the distal radioulnar joint (DRUJ) is a Galeazzi fracture—the 'fracture of necessity' mandating operative fixation (ORIF of the radius restores length and usually reduces the DRUJ; if DRUJ remains unstable, it requires Kirschner wire stabilisation). Monteggia involves the ulna with radial head dislocation; Essex-Lopresti involves the radial head fracture with longitudinal interosseous membrane disruption; Colles fracture is a distal radius fracture, not mid-shaft.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.