A fracture of the radius near the wrist with dislocation of the distal radioulnar joint defines which injury?

• A. Galeazzi fracture
• B. Smith fracture
• C. Colles fracture
• D. Monteggia fracture

Answer: (A)

A distal radius fracture near the wrist with dislocation of the distal radioulnar joint is a Galeazzi fracture. This pattern occurs when the radius breaks in its distal third and the force causes the distal radioulnar joint to become unstable, leading to dislocation of the ulna at the DRUJ. It’s a distinct injury from other wrist-area fractures because the key feature is the combined radius fracture with a concurrent DRUJ dislocation, not just a wrist fracture alone.

Colles fracture is a distal radius fracture with dorsal displacement of the distal fragment but the distal radioulnar joint remains aligned. Smith fracture is a distal radius fracture with palmar (volar) displacement of the fragment, again without DRUJ dislocation. Monteggia fracture involves a fracture of the proximal ulna with dislocation of the radial head at the elbow, not at the wrist. In Galeazzi injuries, treatment often requires fixation of the radius to restore length and forearm rotation and to allow realignment of the DRUJ.