Updated: 12/27/2021

Distal Ulnar Fracture

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  • 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

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