Galeazzi fractures are uncommon, but a combination of open Galeazzi fracture and radial head dislocation has not been described. This article reports on a variant of an open Galeazzi fracture in which concomitant radial head dislocation and coronoid process fracture occurred. Thorough understanding of the mechanisms and influences of pronation injuries of the forearm is essential in order to properly treat this fracture-dislocation. Our evaluation of the individual elements of this composite injury has allowed us to propose a mechanism of injury.