Isolated Ulna Fracture
(Redirected from Midshaft Ulna Fracture)
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
- Fractures
- Pediatric Specific Fractures
- Dislocations & Instability
- Soft Tissue Trauma
- Tendinopathies
- Neuropathies
- Pediatric Considerations
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
- 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
- Acute Compartment Syndrome
- Chronic Pain
- Loss of ADLs
See Also
References
- ↑ Sauder DJ, Athwal GS. Management of isolated ulnar shaft fractures. Hand Clin. 2007 May;23(2):179-84, vi. Review. PubMed PMID: 17548009.