Galeazzi fractures: Factors predicting need for DRUJ stabilization

Background/Purpose This study explored the need for distal radio-ulnar joint (DRUJ) stabilization and its effects on patients’ functional outcomes. Methods A retrospective chart review at level I trauma center was performed to identify all Galeazzi fractures between 2014 and 2022. CPT codes were pulled for any radius fracture, and then X-rays were reviewed to identify the Galeazzi fractures. Once the patient population was identified, chart reviews, including imaging study evaluation, were conducted. Statistics were performed with α =0.05 for the Chi-square tests and t -tests. Results Sixty-five Galeazzi fractures were included. Seventeen (26%) patients required DRUJ stabilization. DRUJ widening and ulnar variance were indicators for DRUJ stabilization ( p = 0.03, p = 0.006, respectively). Fracture distance from DRUJ was not predictive of need for stabilization ( p = 0.405). Current guidelines of ulnar variance > 2 mm and fracture distance <75 mm were not predictive of DRUJ instability ( p = 0.09, p = 0.422, respectively). DRUJ widening >6 mm was associated with the need for stabilization ( p = 0.0012). Patients who underwent DRUJ stabilization had significantly decreased pronation compared to the non-stabilized patients ( p = 0.01), while other range of motion were similar in both groups. Conclusion There are likely combinations of factors that predict DRUJ instability, while they are inconclusive factors on their own. DRUJ stabilization may limit pronation but have otherwise comparable functional outcomes.