JHS - 2026-03-19 - Journal Article
Relationship of Injury Mechanism Energy to Postoperative Wrist Function in Galeazzi Fractures.
Adams JC, Sgaglione MW, Konda SR, Tejwani NC, Egol KA
Topics
Key Takeaway
High-energy Galeazzi fractures yield significantly worse postoperative wrist range of motion across all planes compared to low-energy injuries, despite similar DRUJ symptom rates and nonunion rates between groups.
Summary Depth
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Summary
This retrospective study compared outcomes of high-energy (n=92) versus low-energy (n=24) operatively treated Galeazzi fractures across 23 years at a single institution. High-energy injuries were associated with significantly worse wrist dorsiflexion, palmar flexion, pronation, and supination, and trended toward longer radiographic healing time. Elbow motion, nonunion, infection, contracture, readmission, and DRUJ symptom rates did not differ between groups.
Key Limitation
Absence of patient-reported outcome measures (DASH, PRWE) and functional grip strength data means the clinical magnitude of the observed range-of-motion differences cannot be translated into meaningful impact on daily function or return to work.
Original Abstract
PURPOSE
This study aims to determine the impact of injury mechanism energy level on clinical outcomes following Galeazzi fracture.
METHODS
A retrospective review was performed on 116 skeletally mature patients treated operatively for Galeazzi fractures between January 2000 and October 2023. Patients were categorized by mechanism of injury into high-energy (HE, n = 92) and low-energy (LE, n = 24) groups. Demographics, fracture characteristics, fixation details, and postoperative outcomes, including wrist and elbow range of motion, complications, radiographic healing time, and reoperations, were collected and compared between groups using standard parametric and nonparametric tests with significance set at P < .05. Normality was assessed using the Shapiro-Wilk test, and Fisher exact test was used for categorical variables with low expected counts.
RESULTS
No differences were observed in body mass index or injury characteristics between groups. The HE group was younger and included a higher proportion of men. Wrist motion was more limited in the HE group across dorsiflexion, palmar flexion, pronation, and supination, and time to radiographic healing was longer compared with the LE group. Elbow motion and rates of nonunion, fracture-related infection, contracture, readmission, and distal radioulnar joint symptoms were similar between groups.
CONCLUSIONS
HE Galeazzi fractures were associated with poorer wrist range of motion and toward delayed radiographic healing compared with LE injuries. Recognition of this association underscores the prognostic value of injury mechanism and may inform surgical planning, rehabilitation expectations, and patient counseling.
TYPE OF STUDY/LEVEL OF EVIDENCE
Prognostic III.