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Updated: Aug 13 2012

Distal Ulnar Fracture

Introduction
  • Isolated distal ulnar shaft fracture
    • Mechanism is direct blow:
      • commonly seen in hockey, lacrosse, martial arts
      • when forearm is used to block assault to head and neck ("night stick fracture")
    • Displacement
      • <50% displaced - stable
      • >50% displaced - unstable
  • Ulnar styloid fracture
    • occurs together with distal radius fracture that has high degree of initial displacement
    • associated with distal radioulnar joint (DRUJ) instability
Presentation
  • Wrist pain and deformity
Evaluation
  • X-ray
    • DRUJ is unstable if 
      • lateral xray - ulnar head is subluxed dorsally out of sigmoid notch of radius
      • AP xray - DRUJ is widened
Treatment
  • Closed reduction followed by long arm cast immobilization for 2-4 weeks:
    • followed by bracing
Private Note

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