Our kindergarten-aged daughter went off to school the first day this year and promptly broke her arm. The surgeon calls it a Galeazzi fracture. She’s in a long-arm cast now but we are wondering what the chances are she will end up with full motion when the cast comes off.

Galeazzi fractures of the wrist usually occur as a result of a forceful fall onto the hand/wrist of an outstretched arm. The wrist is extended with the palm face down (though this same injury can occur with the arm outstretched and the palm facing upwards). The force of the impact causes the break. Other trauma such as car accidents, electric shock, and blunt trauma can also result in a Galeazzi wrist fracture.

When the force on impact is enough to break the bone and disrupt the distal radioulnar joint or DRUJ, it is called a galeazzi fracture. Galeazzi fractures of the joint between the two bones of the forearm (the radius and the ulna) can affect children and adults.

The main area affected is the shaft of the radius (forearm bone) down at the end closest to the wrist. Some experts who have studied this problem say Galeazzi fractures occur when the distal one-third of the radial shaft is broken.

Treatment for children is usually with closed reduction and immobilization in a cast that goes up above the elbow. Closed reduction refers to setting the break without cutting the wrist open surgically. Anesthesia is still required to put the child to sleep while performing this procedure and X-rays are used to confirm correct placement of the bones.

If all goes well and the fracture heals, then no further treatment is needed. An excellent outcome has been reported in approximately 75 per cent of all children with this problem. But in some children, the fracture doesn’t heal or the bones shift apart and there is a loss of the reduction. That requires surgery to pin the bones together, recast, and try again.

Many children are amazingly resilient. They come out of the cast with very few problems. Any loss of motion or stiffness is quickly gone and they return to full activity in a matter of days to weeks. Adults with similar injuries often require months of daily rehab to regain functional range of motion and functional ability.

Your surgeon is the best one to advise you on expected outcomes. The location and severity of the fracture along with any complicating associated injuries of the surrounding soft tissue will determine the final result. Family and patient compliance with all instructions provided is another key feature that you can assist with to ensure the best possible results. Good luck!