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Ulnar Shaft Fracture S52.209A 813.22

grade 1 open ulnar shaft fracture

ulnar shaft fracture xray

Forearm Anterior View

ulnar shaft fracture

proximal ulnar shaft fracture xray

synonyms: nightstick fracture, forearm fx, ulnar shaft fracture, ulna fracture 

Ulnar Shaft Fracture ICD-10

 

Ulnar Shaft Fracture ICD-9

  • 813.22(closed, ulna fracture alone)
  • 813.32(open, ulna fracture alone)

Ulnar Shaft Fracture Etiology / Epidemiology / Natural History

  • Most fractures of the ulnar shaft are caused by direct blows and result in minimal soft-tissue injury. 

Ulnar Shaft Fracture Anatomy

Ulnar Shaft Fracture Clinical Evaluation

Ulnar Shaft Fracture Xray / Diagnositc Tests

  • A/P and Lateral of radius/ulna to include elbow and wrist
  • Separate views of wrist and elbow if indicated
  • Template before case

Ulnar Shaft Fracture Classification / Treatment

  • "Non-Displaced" Middle 1/3 (<50%displacement, <10° angulation): functional fracture brace or long arm cast. Ensure distal radioulnar joint is reduced.
  • Displaced Middle 1/3 (>50%displacement, >10° angulation): ORIF
  • Proximal 1/3: ORIF, even non-displaced fractures have high propensity to displace with time.
  • Non-Displaced Distal 1/3 (<5%displacement, <2° angulation): displacement in the distal 1/3 is poorly tolerated. Functional fracture brace or long arm cast if truely nondisplaced. Ensure distal radioulnar joint is reduced.
  • Displaced distal 1/3: ORIF
  • ORIF: 8 cortices above and below recommended
  • Nonsurgical treatment leads to a high rate of union and a good functional outcome. (Zych GA, CORR 1987;219:194)
  • AO Classification
  • Open Fracture Classification

Ulnar Shaft Fracture Associated Injuries / Differential Diagnosis

Ulnar Shaft Fracture Complications

  • Superficial wound infection
  • contracture
  • Nonunion: (incidence is higher for comminuted or displaced fx's)
  • Hardware failure
  • Malunion
  • Painful Hardware
  • Ulnar nerve palsy
  • Radial nerve palsy

Ulnar Shaft Fracture Follow-up Care

  • Post-op: Volar plaster splint with sling. NWB. Active elbow and finger ROM.
  • 7-10 Days: Wound check, Place in funtional brace (interosseous mold). Begin active pronation/supination. Continue active elbow and finger ROM. Activity restrictions. Use for arm for light ADLS only. NWB.
  • 6 Weeks: Gradually resume normal activites provided bony union is evident on xrays.
  • 3 Months: Consider bone stimulator if union is not evident on xray.
  • 6 Months: return to sports / full activities.
  • 1Yr: Follow-up xrays, assess outcomes.

Ulnar Shaft Fracture Review References