Fractures: Galeazzi fracture management in adults: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Fractures: Galeazzi fracture management in adults

Sample item

A 30-year-old falls on an outstretched hand. Radiographs show a displaced fracture of the distal third of the radius with a prominent ulnar head and a widened distal radioulnar joint. What is the preferred treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Open reduction and plate fixation of the radius, then test the DRUJ

A Galeazzi injury is a radial shaft fracture with distal radioulnar joint disruption, and in adults it is a fracture needing surgery because casting fails to hold the radius. Anatomical plating of the radius usually restores joint congruity, after which stability of the DRUJ is tested. Persistent instability needs pinning or repair of the soft tissue stabilisers.

Option by option

  • A. Closed reduction and above-elbow cast

    Casting loses reduction because of the pull of muscles on the radius.

  • B. Open reduction and plate fixation of the radius, then test the DRUJ (correct)

    Correct. Plating the radius and then checking the DRUJ is the standard approach.

  • C. Excision of the ulnar head

    Excising the ulnar head is a salvage procedure and ignores the radial deformity.

  • D. K-wire fixation of the ulna alone

    Fixing only the ulna does not address the radial fracture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Open reduction and plate fixation of the radius, then test the DRUJ. A Galeazzi injury is a radial shaft fracture with distal radioulnar joint disruption, and in adults it is a fracture needing surgery because casting fails to hold the radius.

Why is "Closed reduction and above-elbow cast" not the answer?

Casting loses reduction because of the pull of muscles on the radius.

Why is "Excision of the ulnar head" not the answer?

Excising the ulnar head is a salvage procedure and ignores the radial deformity.

Why is "K-wire fixation of the ulna alone" not the answer?

Fixing only the ulna does not address the radial fracture.

What concept does this question test?

It tests Fractures: Galeazzi fracture management in adults in Orthopaedics. Anatomical plating of the radius usually restores joint congruity, after which stability of the DRUJ is tested. Persistent instability needs pinning or repair of the soft tissue stabilisers.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Fractures: Galeazzi fracture management in adults?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.