Volume 1, Case 16

Galeazzi's Injury
Radiology Cases in Pediatric Emergency Medicine
Volume 1, Case 16
Loren G. Yamamoto, MD, MPH
Stanley M.K. Chung, MD

A 12 year old male is brought to the ED after injuring his forearm rollerblading. He fell onto his palm and noted pain and a deformity in his forearm. Examination revealed normal vital signs and findings limited to his left arm. His clavicle, shoulder, humerus, and hand were non-tender. He was reluctant to move his shoulder since his forearm was in a splint and sling. There was an obvious angulation at the mid-forearm. He could move all his fingers. No circulatory or sensory deficits were detected. Radiographs of his forearm were obtained.

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X-ray

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The radiographs show an angulated distal radius and ulna fracture, a fracture through the physis of the distal ulna, and a dislocation of the distal ulna (radioulnar dislocation). What type of Salter-Harris fracture is present at the distal ulna? If you have difficulty with the Salter-Harris classification, review Case 18 (Salter-Harris). This is probably a SH type I fracture, although small parts of the metaphysis may still be attached to the fracture segment, making it a type II.

What is your Diagnosis?

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Loren Yamamoto, MD, MPH 
Associate Professor of Pediatrics
University of Hawaii John A. Burns School of Medicine
loreny@hawaii.edu