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Isolated Ulna Fracture

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Other Names

  • Ulnar Shaft Fracture
  • Nightstick Fracture

Background

  • Typically mid-shaft diaphyseal Ulna fractures as a result of a direct blow
  • Considered a defensive wound to protect the head and neck

Pathophysiology

Associated Injuries


Risk Factors

  • Unknown

Differential Diagnosis


Clinical Features

  • General: Physical Exam Forearm
  • History
    • Should describe a history of trauma
  • Physical Exam
    • In addition to forearm, thorough elbow and wrist examination should be performed

Evaluation

Midshaft Ulnar Fracture
  • Radiographs
    • Standard 3 views (AP, Lateral, Oblique)

Classification

  • Stable[1]
    • Mid or distal one-third fractures
    • Meets no criteria of instability
  • Unstable
    • > 50% displacement
    • > 10° angulation
    • Proximal one-third shaft fractures
    • Unstable PRUJ or DRUJ

Management

Nonoperative

  • Limited studies to guide management
  • Indications:
    • < 10-15° angulation
    • More than 50% to 75% fracture opposition

Operative

  • Considered unstable if:
    • Unstable (see classification)
    • Displacement > 50%
    • Angulation > 10-15°
    • Angulation or displacement towards the interosseous membrane
    • Interosseous membrane disrupted
    • Associated injuries

Return to Play

  • Highly variable
  • Discretion of surgeon

Complications


See Also


References


  1. Sauder DJ, Athwal GS. Management of isolated ulnar shaft fractures. Hand Clin. 2007 May;23(2):179-84, vi. Review. PubMed PMID: 17548009.
Created by:
John Kiel on 4 July 2019 07:11:30
Authors:
Last edited:
31 October 2020 00:12:16
Categories:
Trauma | Osteology | Wrist | Forearm | Upper Extremity | Fractures | Acute