Isolated ulna fracture: Difference between revisions
No edit summary |
|||
| (3 intermediate revisions by 2 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Also known as a "nightstick" fracture | *Also known as a "nightstick" fracture | ||
**Characteristic defensive fracture sustained when the patient tries to protect themselves from an overhead blow | |||
*Most often due to direct trauma | *Most often due to direct trauma | ||
==Clinical Features== | ==Clinical Features== | ||
*Pain/swelling, deformity | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 9: | Line 11: | ||
==Evaluation== | ==Evaluation== | ||
*Assess distal pulse, motor, and sensation | |||
*2-view forearm x-ray | *2-view forearm x-ray | ||
==Management== | ==Management== | ||
{{General Fracture Management}} | |||
===Immobilization=== | |||
*[[Splint]] | |||
==Disposition== | |||
*If splinted and stabilized, can be discharged after consultation with Ortho | |||
*Admit for: | |||
**[[Open fracture]] | |||
**Signs of neurovascular injury | |||
**Concern for [[compartment syndrome]] | |||
===Specialty Care=== | |||
*Stable: short arm cast | *Stable: short arm cast | ||
*[[Long arm posterior splint]] with 90 degrees of elbow flexion and the hand in a neutral position | *[[Long arm posterior splint]] with 90 degrees of elbow flexion and the hand in a neutral position | ||
| Line 18: | Line 34: | ||
**>10% angulation | **>10% angulation | ||
**Involvement of proximal 1/3 | **Involvement of proximal 1/3 | ||
==See Also== | ==See Also== | ||
[[Forearm Fracture]] | *[[Forearm Fracture]] | ||
==References== | ==References== | ||
Latest revision as of 04:39, 18 September 2019
Background
- Also known as a "nightstick" fracture
- Characteristic defensive fracture sustained when the patient tries to protect themselves from an overhead blow
- Most often due to direct trauma
Clinical Features
- Pain/swelling, deformity
Differential Diagnosis
Forearm Fracture Types
- Distal radius fractures
- Radia ulna fracture
- Isolated radius fracture (proximal)
- Isolated ulna fracture (i.e. nightstick)
- Monteggia fracture-dislocation
- Galeazzi fracture-dislocation
- Forearm fracture (peds)
Evaluation
- Assess distal pulse, motor, and sensation
- 2-view forearm x-ray
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Immobilization
Disposition
- If splinted and stabilized, can be discharged after consultation with Ortho
- Admit for:
- Open fracture
- Signs of neurovascular injury
- Concern for compartment syndrome
Specialty Care
- Stable: short arm cast
- Long arm posterior splint with 90 degrees of elbow flexion and the hand in a neutral position
- Unstable: ORIF
- >50% displacement
- >10% angulation
- Involvement of proximal 1/3