Figure A shows a Galeazzi fracture (distal 1/3 radial shaft fracture with associated distal radioulnar joint dislocation). In this injury, an inability to reduce the distal radioulnar joint in a closed fashion is most commonly secondary to interposition of the extensor carpi ulnaris tendon. Early recognition of the dislocation of the ulna and ECU into the DRUJ and their significance may avoid poor results. The referenced study by Biyani et al reports a case in which both the extensor carpi ulnaris and extensor digiti minimi tendons were displaced on either side of the ulnar head. The referenced study by Budgen et al presents a case of a Galeazzi fracture dislocation with an irreducible distal radioulnar joint. The referenced study by Paley et al reports two cases of distal radioulnar joint (DRUJ) disruption and diastasis secondary to distal radial fractures that were associated with displacement of the ulnar styloid and extensor carpi ulnaris (ECU) into the DRUJ. Both cases had a palpable empty ECU tendon sulcus.
Biyani A, Bhan S: Dual extensor tendon entrapment in Galeazzi fracture-dislocation: A case report. J Trauma 1989;29:1295-1297.
PMID:2769817 (Link to Abstract)
Budgen A, Lim P, Templeton P, Irwin LR. Irreducible Galeazzi injury. Arch Orthop Trauma Surg. 1998;118(3):176-8.
PMID:9932197 (Link to Abstract)
Paley D, McMurtry RY, Murray JF. Dorsal dislocation of the ulnar styloid and extensor carpi ulnaris tendon into the distal radioulnar joint: The empty sulcus sign. J Hand Surg Am 1987;12:1029-1032.
PMID:3693829 (Link to Abstract)