25525 Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (Galeazzi fracture/ dislocation), includes percutaneous skeletal fixation, when performed

Name of the Procedure:

Open treatment of radial shaft fracture with internal fixation and closed treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), including percutaneous skeletal fixation.

Summary

This surgical procedure treats a broken radial shaft (part of the forearm bone) and a dislocated distal radioulnar joint, commonly known as a Galeazzi fracture/dislocation. The radial shaft fracture is stabilized with a metal implant, and the dislocation of the distal radioulnar joint is corrected without making an incision, sometimes using pins for temporary stabilization.

Purpose

The procedure addresses fractures of the radial shaft accompanied by dislocation of the distal radioulnar joint. The main goals are to realign the fractured bone, stabilize the joint, restore arm function, and prevent complications such as improper healing or chronic joint instability.

Indications

• Acute, traumatic fractures of the radial shaft
• Dislocation of the distal radioulnar joint
• Significant pain, swelling, and deformity of the forearm
• Inability to rotate the forearm or use the hand fully
• Best suited for physically active individuals who require optimal arm function.

Preparation

• Patients may need to fast several hours before the surgery.
• Preoperative imaging (X-rays, CT scans) to assess the fractures and dislocation.
• Medication review and adjustment, including blood thinners.
• Pre-surgery physical examination and discussion about anesthesia.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision and Exposure: An incision is made over the radial shaft, and the fracture site is accessed.
3. Reduction and Fixation: The bone fragments are realigned and held together using metal plates and screws.
4. Joint Reduction: The distal radioulnar joint is manually manipulated back into place.
5. Percutaneous Fixation: If needed, pins are inserted through the skin to stabilize the joint.
6. Closure: The incision is closed with sutures, and a sterile dressing is applied.
7. Imaging: Intraoperative X-rays confirm proper alignment.

Duration

Approximately 2-3 hours, depending on the complexity.

Setting

Typically performed in a hospital operating room or specialized surgical center.

Personnel

• Orthopedic Surgeon
• Surgical Assistants
• Anesthesiologist
• Operating Room Nurses

Risks and Complications

• Infection at the surgical site
• Nerve damage or irritation
• Nonunion or malunion of the fracture
• Loss of range of motion
• Postoperative pain and swelling
• Need for additional surgery if the fixation fails

Benefits

• Proper alignment and stabilization of the fracture
• Restoration of arm and hand function
• Reduction in pain and prevention of long-term complications
• Easier and quicker recovery compared to untreated fractures

Recovery

• Immobilization with a cast or splint for several weeks.
• Gradual increase in activity as healing progresses.
• Physical therapy to regain strength and mobility.
• Regular follow-up visits to monitor bone healing through X-rays.
• Full recovery may take several months.

Alternatives

• Non-surgical casting (less effective for severe fractures/dislocations, longer recovery)
• Closed reduction and casting (may not provide adequate fixation)
• External fixation (less commonly used, more external hardware)

Patient Experience

• During the procedure: Complete sedation or regional numbness.
• After the procedure: Initial pain and swelling managed with medication.
• Discomfort with immobilization devices.
• Progressive improvement in function with physical therapy.
• Detailed post-op instructions provided to promote optimal recovery.