Distal Ulna Fracture

Other Names

• Ulnar styloid fracture
• Ulnar head fracture
• Distal ulnar neck

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Background

• Distal Ulna fractures include
  • Ulnar styloid fracture
  • Ulnar head fracture
  • Distal ulnar neck

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Pathophysiology

• Ulnar styloid fractures
  • Typically a small avulsion fracture
  • Seen in about 60% of distal radius fractures

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Risk Factors

• Osteoporosis

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Differential Diagnosis

• Fractures
  • Distal Radius Fracture
    • Bartons Fracture
    • Chauffers Fracture
    • Colles Fracture
    • Die-Punch Fracture
    • Radial Styloid Fracture
    • Smiths Fracture
  • Distal Ulna Fracture
  • Carpal Fractures
    • Scaphoid Fracture
    • Lunate Fracture
    • Triquetrum Fracture
    • Pisiform Fracture
    • Trapezium Fracture
    • Trapezoid Fracture
    • Capitate Fracture
    • Hamate Fracture
  • Essex Lopresti Fracture
• Dislocations
  • Wrist Dislocation (Radiocarpal and/or Ulnocarpal)
  • Carpometacarpal Joint Dislocation
  • Distal Radioulnar Joint Dislocation
  • Lunate Dislocation
  • Perilunate Dislocation
• Instability & Degenerative
  • Scapholunate Instability
  • Lunotriquetral Instability
  • Scaphoid Nonunion Advanced Collapse
  • Distal Radial Ulnar Joint Instability
  • Kienbocks Disease
  • Dorsal Wrist Impingement
  • Carpal Instability
• Tendinopathies & Ligaments
  • De Quervain's Tenosynovitis
  • Intersection Syndrome
  • TFCC Injury
  • Wrist Tendinopathies
  • Extensor Carpi Ulnaris Tendinopathy
• Neuropathies
  • Carpal Tunnel Syndrome
  • Pronator Teres Syndrome
  • Anterior Interosseus Nerve Syndrome
  • Posterior Interosseus Nerve Syndrome
  • Guyon Canal Syndrome
  • Wartenbergs Syndrome
• Pediatric Considerations
  • Distal Radial Epiphysitis (Gymnast's Wrist)
  • Torus Fracture
• Arthropathies
  • Wrist Osteoarthritis
  • Scaphotrapeziotrapezoidal Joint Arthritis (STT Arthritis)
  • Rheumatoid Arthritis
  • Gout
• Cartilage
  • Osteochondral Defect
• Vascular
  • Hypothenar Hammer Syndrome
• Other
  • Ganglion Cyst of Wrist
  • Ulnar Impingement Syndrome
  • Infectious Tenosynovitis

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Clinical Features

• General: Physical Exam Wrist
• Typically swelling, ecchymosis, deformity
• Tenderness to palpation of distal ulna

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Evaluation

Radiographs

• Standard Radiographs Wrist
• Typically satisfactory

CT scan

• Important to evaluate intra-articular injuries or for surgical planning

MRI

• Evaluate for soft tissue injuries

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Classification

• N/A

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Management

Nonoperative

• There is little scientific support to guide the management of distal ulnar fractures
• Most distal ulna fractures can be managed nonoperatively
• Splint: Ulnar Gutter Splint
• Cast: Ulnar Gutter Cast

Operative

• Indications
  • Open
  • Unstable
  • Other co-occurring

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Return to Play

• Needs to be updated

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Complications

• Distal Radioulnar Joint Disruption
• TFCC Injury

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See Also

• Internal
  • Forearm Pain (Main)
  • Elbow Pain (Main)
  • Wrist Pain (Main)
  • Forearm Anatomy (Main)
  • Physical Exam Wrist
• External
  • Sports Medicine Review Wrist Pain: https://www.sportsmedreview.com/by-joint/wrist/

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