Nightstick fracture (ulna)

Last revised by Leonardo Lustosa on 16 Apr 2023

Nightstick fractures are isolated fractures of the ulna, typically transverse and located in the mid-diaphysis and usually resulting from a direct blow. It is a characteristic defensive fracture when the patient tries to ward off an overhead blow from an assailant (or local law enforcement officer) brandishing a bar-like weapon.

This is a defense-type fracture and cases should prompt concern for a patient's safety, it is rare that an isolated fracture of the ulna can be the result of falling over 5. Intimate partner violence amongst other things should be considered in patients where the clinical details do not match the fracture 4,5.

Radiographs are most often sufficient to diagnose an isolated ulnar shaft fracture.

Nondisplaced fractures are much more likely secondary to assault than displaced ones 5.

Although nightstick fractures are typically closed fractures, they have a higher rate of delayed union or non-union.

Historically this fracture was seen not infrequently due to a strike from a policeman’s baton (known as a nightstick in the USA).

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