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Shaft of Ulna Fracture
Related Subjects: |Shoulder Anterior Dislocations |Shoulder:Posterior Dislocation |Elbow Dislocation |Olecranon Fracture |Distal Humerus Fracture |Radial Head and Neck Fractures |Forearm Fractures |Shaft of Ulna Fracture |Wrist Colles Fracture |Wrist Smith’s Fracture
🦴 Introduction
- A shaft of ulna fracture, also known as a “Night-stick” fracture, usually involves the middle third of the ulna.
- Caused by a direct blow to the forearm, classically when the patient raises their arm defensively to protect the face.
🔍 Clinical Features
- Forearm Deformity: Visible abnormality along the ulna.
- Palpable Step or Crepitus: Felt over the ulnar border.
- Pain & Tenderness: Localised along the mid-shaft of ulna.
- Neurovascular Status: Always assess and document — especially ulnar nerve function:
- Motor: Finger abduction/adduction.
- Sensory: Little finger border of the hand.
🩻 X-Ray Findings
- Request Radius & Ulna X-rays: Ensure the whole forearm is imaged.
- Check Elbow: Obtain lateral elbow X-ray to assess the radial–capitellar line.
- Rule out Monteggia Fracture: Ulna fracture with associated radial head dislocation.
🛠️ Management
- 💊 Analgesia: Provide adequate pain control.
- 🩹 Immobilisation:
- Apply a long-arm back-slab (above elbow).
- Support with a broad-arm sling for comfort.
- 📞 Orthopaedic Referral: Refer to the on-call team for assessment.
- 📅 Follow-Up: Arrange Virtual Fracture Clinic (VFC) review.
⚠️ Key Teaching Points
- Night-stick fractures are usually stable and often managed conservatively with immobilisation.
- Always exclude Monteggia fracture-dislocation — missing this can lead to chronic instability and poor function.
- Document CSM (circulation, sensation, movement) before and after splinting.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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