Which fracture is a radial fracture with distal ulna dislocation?

• A. Chauffeur's
• B. Monteggia
• C. Barton's
• D. Galeazzi

Answer: (D)

This pattern is a distal radius fracture with dislocation of the distal radioulnar joint. That combination defines a Galeazzi fracture. The injury typically results from a fall on an outstretched hand with the forearm in a position that drives load through the radius while the distal radioulnar joint becomes unstable, often due to disruption of the interosseous membrane and TFCC. On X-ray you’d look for a fracture of the distal third of the radius with loss of congruity at the DRUJ; sometimes the ulna shifts relative to the radius on the lateral view.

This differentiates it from the other injuries: a Monteggia fracture is a proximal ulna fracture with radial head dislocation at the elbow; a Barton's fracture is a distal radius fracture with radiocarpal (carpal) dislocation or intra-articular involvement; a Chauffeur's fracture is a radial styloid avulsion. The key concept is distal radius fracture plus DRUJ disruption, i.e., Galeazzi.