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June 1968

Unstable Fracture-Dislocations of the ForearmThe Monteggia and Galeazzi Lesions

Author Affiliations

Kansas City, Kan
From the Department of Surgery, Section of Orthopedic Surgery, University of Kansas Medical Center, Kansas City.

Arch Surg. 1968;96(6):999-1007. doi:10.1001/archsurg.1968.01330240145034

FRACTURE-dislocations of the forearm are not common injuries. They are inherently unstable due to a variety of factors which are poorly understood by many surgeons. Mistakes in their management account for a high incidence of poor results.

In fractures of the forearm, any shortening of one bone of the forearm necessitates either a fracture of the other with equivalent shortening, or a dislocation at the proximal or distal radio-ulnar joint (Fig 1). The proximal and distal joints must be carefully scrutinized in every fracture of the forearm. When the ulna is fractured and shortened, the proximal radio-ulnar joint dislocates (the Monteggia fracture). When the opposite occurs (that is, the radius breaks and shortens), the distal radio-ulnar joint dislocates, resulting in the Galeazzi or "reverse Monteggia" fracture.

Reduction of these fracture-dislocations must be accurate and must be maintained until healing is complete, or there will be encroachment on the interosseous membranes

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