Galeazzi fracture

　　Galeazzi fracture is characterized by significant injury caused by direct external force, and it is more common in children. The pathological changes are mainly manifested as injuries to the distal forearm bone and various types of injuries to the elbow, such as contusions or machine crush injuries. The most common is the fracture of the middle and lower third of the radius with dislocation of the distal radioulnar joint. Galeazzi fracture also occurs in the transmission of violence. For example, in a single external force, the distal forearm fracture may occur due to the transmission of force, and it is characterized by various types of injuries to the ipsilateral elbow, but some may also involve the proximal humerus. Fractures of this kind can be caused by falling and using the hand to support the ground.

　　What complications can Gai's fracture easily lead to

　　Gai's fracture is positively correlated with the severity of injury. Fractures with no significant displacement only have pain, swelling, and tenderness; those with significant displacement will show shortening and angular deformity of the radius, swelling and significant tenderness of the distal radius-ulna joint, bulging of the ulna head, and rare nerve and vascular injuries. This type of fracture is generally divided into the following three types:

　　1. Green branch type:It occurs in children, with the radius showing a green branch fracture, the ulnar head or epiphysis separation, or the distal radius-ulna joint showing a separation. This type of treatment is relatively easy and has a good prognosis.

　　2. Simple type:It is a fracture of the distal radius, accompanied by dislocation of the distal radius-ulna joint. The fracture is often transverse, oblique, or spiral, and generally has significant displacement.

　　3. Double fracture type:In addition to fractures of the distal radius and dislocation of the radius-ulna subarticular joint, the ulna shaft is also often accompanied by fractures, or there are ulnar traumatic bends caused by incomplete fractures. The latter situation is often caused by machinery injuries and is more serious, often being an open wound with complex treatment. In the case of double fractures, the direction of displacement of the fracture ends mainly depends on the following muscles:

　　1. Biceps brachii:It can cause shortening and malformation of the fracture ends.

　　2. Pronator quadratus:To make the distal radius converge inward.

　　3. Extensor pollicis longus and abductor pollicis longus:Strengthen the function of the above two groups of muscles.

　　Gai's fracture is caused by direct impact on the distal 1/3 of the radius on the radial side due to blows or machinery entanglement; it can also be caused by falling and the transmission of stress when the hand supports the ground, resulting in a fracture. Therefore, preventive work should start from the details of daily life.

　　The auxiliary examination methods for Gai's fracture mainly include X-ray examination:

　　X-ray imaging shows a transverse or short oblique fracture at the junction of the lower 1/3 of the radius, usually without severe comminution. If the radius fracture is significantly displaced, the distal radius-ulna joint will be completely dislocated. In the anteroposterior X-ray film, the radius is shortened, the distance between the distal radius and ulna is reduced, and the radius is close to the ulna. In the lateral view, the radius head is angulated towards the palm side, and the ulna head is protruding towards the dorsal side.

　　An in-depth introduction to the dietary and health care of Gai's fracture, as well as the therapeutic diet recipes for Gai's fracture.

　　First, suitable diet

　　1. It is advisable to eat more vegetables rich in fiber and to consume foods that promote gastrointestinal digestion and defecation, such as bananas and honey.

　　2. In the early stage, one should eat some foods that promote blood circulation, remove blood stasis, and promote the dispersal of Qi, such as vegetables, soy products, fish soup, eggs, etc.

　　3. In the middle stage, one can eat some foods that help nourish the body, relieve pain, remove blood stasis, and promote the formation of new tissues, such as bone soup, Cordyceps chicken soup, animal liver, etc.

　　4. In the later stage, one can eat more foods that nourish the liver and kidneys, invigorate the Qi and nourish the blood, and relax the tendons and meridians, which can help the formation of bone callus, such as chicken soup with old hen, pork bone soup, sheep bone soup, etc.

　　Secondly, dietary taboos

　　1. Avoid blind supplementation of calcium.

　　2. Avoid indigestible foods.

　　3. Avoid eating too much meat and drinking braised bone soup.

　　It is not difficult to reduce the Galezzi fracture under traction, but it is very difficult to maintain the position of reduction, because there are several forces that pull the distal segment of the radius and make it dislocate again, which is what Hughston (1957) proposed:

　　1. The contraction of the pronator quadratus makes the distal segment of the radius fracture closer to the ulna.

　　2. The traction of the brachioradialis muscle causes the distal segment of the radius fracture to shorten in the proximal direction.

　　3. The contraction of the abductor pollicis longus and extensor pollicis longus makes the distal segment of the radius fracture closer to the ulna and shorter in the proximal direction. Even if the wrist joint is fixed in a varus position with a plaster cast, the above forces still exist, so the success rate of closed reduction is very low, and the treatment result is extremely unsatisfactory.

　　In the cases reported by Hughston, the adverse rate of closed reduction treatment reached 92%. In order to obtain good forearm rotation function and avoid the disorganization of the distal radioulnar joint, the radius fracture must be anatomically reduced, and therefore, open reduction and internal fixation is almost the only choice. The operation uses the Henry incision, uses a sufficient length and strength of the plate to fix the radius fracture, and the plate is placed on the palmar surface of the radius. After the operation, the short arm plaster cast should be used to fix the forearm and wrist in a neutral position for 3 to 4 weeks, so that the tissue around the distal radioulnar joint can heal, avoid late instability of the distal radioulnar joint, and actively carry out functional exercise after the cast is removed.

　　The prognosis is generally good. In cases with poor reduction and internal malunion of the radius, the function is poor. In old cases, the operation of osteotomy of the head of the ulna or bone graft fusion can be considered as a remedial measure.