A 28-year-old falls on an outstretched hand. X-ray shows a Galeazzi fracture-dislocation. Which combination correctly describes this injury?

• A Fracture of proximal ulna with dislocation of radial head
• B Fracture of distal radius with dislocation of distal radio-ulnar joint (DRUJ) ✓
• C Fracture of proximal radius with dislocation of distal radio-ulnar joint
• D Fracture of distal ulna with dislocation of proximal radio-ulnar joint

Explanation

Galeazzi fracture-dislocation comprises a fracture of the distal third of the radius with disruption of the distal radio-ulnar joint; it is called a 'fracture of necessity' because the DRUJ dislocation almost invariably accompanies the radial fracture. Monteggia fracture is the reverse: proximal ulna fracture with radial head dislocation. Galeazzi requires open reduction and internal fixation of the radius in adults, followed by DRUJ stability assessment; isolated closed management fails due to the deforming force of pronator quadratus.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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