Isolated distal ulna fracture
Kicked to forearm at Taekwondo. Pain and swelling at distal ulna/radius. Tender over dorsal aspect of carpal bones.
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Fracture through the distal shaft of the ulna with medial displacement of the distal fragment. There is some shortening. Plaster backslab is noted.
2 case questions available
Isolated distal ulna fracture are usually the result of direct force to the ulna, as was the mechanism in this case.
Displaced or comminuted distal ulna neck fractures (those that occur within 5cm of the head) can disrupt the distal radioulnar joint and may cause pain or dysfunction at this joint in the future if not adequately treated 1.
Stable fractures can be treated with immobilisation with an above elbow cast. Distal ulna neck/shaft fractures that concurrently occur with a distal radius fracture should be assessed after the radius fracture has been definitely treated. ORIF may be necessary in those distal ulna fractures that cannot be adequately reduced or appear unstable 1.
This patient went on to have plate and screw internal fixation.
- Logan AJ, Lindau TR. The management of distal ulnar fractures in adults: a review of the literature and recommendations for treatment. Strategies Trauma Limb Reconstr. 2008;3 (2): 49-56. Strategies Trauma Limb Reconstr (full text) - doi:10.1007/s11751-008-0040-1 - Free text at pubmed - Pubmed citation