Isolated ulna fracture: Difference between revisions
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===Immobilization=== | ===Immobilization=== | ||
*[[Splint]] | |||
*[[ | |||
==Disposition== | ==Disposition== | ||
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**Signs of neurovascular injury | **Signs of neurovascular injury | ||
**Concern for [[compartment syndrome]] | **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 | |||
==See Also== | ==See Also== | ||
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