Hungarian Radiology

[Galeazzi fracture in childhood]

LOMBAY Béla

JULY 15, 2009

Hungarian Radiology - 2009;83(02)

[The Galeazzi fracture dislocation is a fracture of the distal radius with dislocation of the distal radio-ulnar joint. In 1934 Galeazzi an Italian surgeon published an article with his experiences of this injury pattern. Although the Galeazzi fracture - dislocation is a well known injury with characteristic clinical and X-ray signs we couldn’t find any article in the literature about the differentiation of different types of this injury. Our experiences showed that there are three characteristic types seeing on the plan film: 1. extension type: radial shaft fracture with dorsal angle and ulnar dislocation in volar direction; 2. flexion type: radial shaft fracture with volar angle and ulnar dislocation of dorsal in direction; 3. abduction type: radial shaft fracture with radial angle and ulnar dislocation in ulnar direction. The three types were published in a Hungarian textbook in 1987.]

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[INTRODUCTION - The number of Caesarean sections has been dramatically increasing worldwide, and also in Hungary in the last decade. In case of pregnancy following a preliminary Caesarean section it is always questioned if repeated Caesarean section or vaginal birth is required. The authors try to draw a conclusion from the thickness and the structure of the uterinal scar. The aim of the current study is to assess the additional role of uterinal MR examination undertaken between two births. PATIENTS AND METHODS - During our retrospective preliminary study T2 weighted sagittal images of uterinal MR examinations of 13 female patients were analysed. The presence of scar line was evaluated for thickness (millimetres, mm). This measurement was compared with the surgical report following consequent Caesarean section. Thus, a correlation was made between the surgical scar found at the repeated Caesarean section and the structure of the uterine scar seen by MR examination (between two births) which could play a role in the indication of the next birth. RESULTS - Three of our 13 patients gave birth via vagina (VBAC), and 10 via repeated Caesarean sections. According to the descriptions of the surgical scar the scars thinned out in six cases, whereas they made thickness in four. According to the appearance of the place of incision the scar was homogeneous and hypointens in nine cases, and inhomogeneous but basically hypointense in one case. According to the description of surgery in the MR examination the thinned out scar was thinner than 6 mm in 4 cases, and thicker than 6 mm in two cases. According to the description of surgery in the MR examination the nonthinned out scar was thinner than 6 mm in three cases, and thicker than 6 mm in one case. In two patients of three who gave birth via vagina the scar was thicker than 6 mm in the MR examination, and thinner than 6 mm in one case, the MR appearance of the scar was homogeneous and hypointens in two cases and complied with the original zonal anatomy in one case. CONCLUSION - In case repeated Caesarean section is not necessary from the aspect of the foetus or the mother, uterinal MR examination is of an additional significance in the complex indication of birth following a previous Caesarean section. The thickness, structure and signal intensity of the uterinal scar may provide a useful additional information.]

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