📌 Galeazzi Fracture–Dislocation — Wrist MRI Focus

https://youtu.be/vvV4DYmUenw

https://youtube.com/shorts/WipVHnQZo3g

 

 

Why the wrist matters

• Galeazzi fracture is not only a radial shaft injury.
• The key problem is often DRUJ instability, caused by disruption of the TFCC stabilizers.

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Sagittal MRI: Best plane for ulnar-sided stabilizers

• Sagittal imaging clearly demonstrates the TFCC ligamentous components, not just the articular disc.

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Normal TFCC Stabilizing Core

• The central articular disc is present,
  but true DRUJ stability depends on the radioulnar ligaments:

Dorsal Radioulnar Ligament

• Dorsal ulnar head → distal radius
• Tight in pronation

Volar Radioulnar Ligament

• Volar ulnar head → distal radius
• Tight in supination

➡️ Tears of these ligaments lead directly to DRUJ instability.

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Distal Continuation: Volar Ulnocarpal Sling

• The volar radioulnar ligament continues into:

These form the volar ulnocarpal stabilizing sling.

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MRI Findings in This Galeazzi Case

• Ulnar styloid process fracture
• ECU tendon longitudinal splitting
• Combined tears of:

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Take-home Message

This is not just a fracture.
It is a complete disruption of the ulnar-sided stabilizers, explaining persistent DRUJ instability.

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