What is a Ulnar Fracture?
An ulnar fracture is a break in the ulna, one of the two long bones of the forearm (the other being the radius). The ulna runs from the elbow to the wrist on the side of the little finger and plays a key role in forearm stability and elbow function. Ulnar fractures can occur alone (isolated ulnar fracture) or with other injuries, such as a radial fracture or elbow dislocation (e.g., Monteggia fracture).
What are the Causes of Ulnar Fractures?
Ulnar fractures occur when excessive force is applied to the forearm. The common causes include:
- Direct blow to the forearm (commonly called a nightstick fracture)
- Falls on an outstretched hand
- Sports injuries
- Road traffic accidents
- Twisting injuries or high-impact trauma
- Workplace accidents
The severity and pattern of the fracture depend on the type of force, direction of impact, and bone health.
What are the Signs and Symptoms of Ulnar Fracture?
The signs and symptoms of an ulnar fracture vary depending on the severity and location of the break, but commonly include:
- Pain at the site of injury, which worsens with movement
- Swelling and tenderness along the forearm
- Bruising or discoloration of the skin
- Visible deformity or abnormal angulation of the forearm in displaced fractures
- Difficulty or inability to move the forearm, wrist, or elbow
- Pain with gripping or rotating the forearm (pronation/supination)
- Crepitus (a grinding or cracking sensation) in some cases
- Numbness or tingling if nearby nerves are affected
- Open wound with bone exposure in open (compound) fractures
Prompt medical evaluation is important to prevent complications such as malunion, nerve injury, or joint stiffness.
How is Ulnar Fracture Diagnosed?
An ulnar fracture is diagnosed through a combination of clinical evaluation and imaging studies. The doctor begins with a physical examination to assess pain, swelling, deformity, and tenderness along the forearm, while also checking nerve function and blood supply. This is followed by X-ray imaging of the forearm, including the elbow and wrist joints, to confirm the presence of a fracture, determine its location, and assess alignment. In complex cases, suspected joint involvement, or high-energy trauma, a CT scan may be used for more detailed evaluation.
How is Ulnar Fracture Treated?
Ulnar fracture treatment depends on the location, severity, and stability of the fracture, as well as any associated injuries. Non-displaced or stable fractures are usually treated conservatively with immobilization using a splint or cast, along with pain management and regular X-ray follow-up to ensure proper healing. Displaced, unstable, open fractures, or fractures associated with joint dislocation often require surgical treatment, typically involving open reduction and internal fixation with plates and screws. After immobilization or surgery, rehabilitation and physical therapy are important to restore strength, flexibility, and normal function of the forearm, wrist, and elbow.
