[Dislocation fractures of the forearm. Galeazzi, Monteggia, and Essex-Lopresti injuries].

Combined forearm fractures are identified according to their location as Galeazzi, Monteggia, or Essex-Lopresti injuries. The feature common to these three forms is the combination of a forearm fracture with instability of the distal or proximal radioulnar joint. Appropriate management of the injury at an early stage is indispensable to achieve good functional results. Galeazzi fractures should initially be treated by open reduction and correct anatomy restored by plate osteosynthesis. Fixation of the distal radioulnar joint with Kirschner wires should be performed in cases of persistent dislocation or instability and limited to 6 weeks. Monteggia fractures should be surgically approached, taking care not to overlook possible additional injuries (radial head, coronoid process). Essex-Lopresti injuries are treated by surgical reconstruction of the radial head, and in cases of comminuted fractures by implanting a radial head prosthesis. Subsequent treatment entails at least 14 days immobilization in a supinated position using an upper arm cast. Early functional therapy should follow when all three forms of injuries have been treated.