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June 1968

Unstable Fracture-Dislocations of the Forearm: The 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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