Isolated ulna fracture: Difference between revisions
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==Background== | ==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 | *Most often due to direct trauma | ||
==Clinical Features== | |||
*Pain/swelling, deformity | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Forarm fracture DDX}} | {{Forarm fracture DDX}} | ||
==Evaluation== | |||
*Assess distal pulse, motor, and sensation | |||
*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 | ||
*Unstable: ORIF | *Unstable: ORIF | ||
**>50% displacement | **>50% displacement | ||
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==See Also== | ==See Also== | ||
[[Forearm Fracture]] | *[[Forearm Fracture]] | ||
==References== | |||
<references/> | |||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
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