What is an ulnar fracture?

An ulnar fracture is a fracture in the ulna, one of the bones of the forearm. This type of fracture can be seen in people of all ages, and is usually caused by a direct impact to the ulna, such as might occur from a fall or physical argument. The symptoms of an ulnar fracture are very distinctive: the patient typically experiences extreme pain and limited range of motion, and in the case of an open fracture, pieces of the broken bone protrude through the skin.

The other bone in the forearm is the radius. Together, the radius and ulna extend from the elbow to the wrist, and both bones are critical to the function of the arm. Independent fractures of either bone are usually caused by impacts, while twisting the forearm or bending the arm outside its normal range of motion will cause a bony forearm fracture involving the radius and ulna. This type of fracture often takes the form of a spiral fracture, and almost always requires surgery.

If an ulnar fracture is relatively simple, it can be stabilized with a brace or cast and allowed to heal. During the healing process, the patient's range of motion may be limited, and certain lifestyle adjustments may be necessary to protect the fractured bone while it heals. For example, a patient in a cast usually cannot play contact sports. Complications can include infection, improper healing, or nonunion, in which the bone simply does not heal, despite being given time to do so.

More complex fractures will require surgical stabilization. This is accomplished by putting the patient under general anesthesia and using a set of pins and plates to fix the bone in place. After surgery, the arm is placed in a cast to keep it immobilized while it heals. Once the ulnar fracture heals, the pins can be removed or left in place, depending on the patient's situation and preferences. Complications of surgical stabilization may include nonunion, adverse reactions to anesthesia, and infection.

In a unique type of ulnar fracture known as a Monteggia fracture, the fracture of the ulna also involves a rupture of the joint with the radius. This type of fracture most commonly occurs when the elbow receives a strong impact, such as when someone breaks a fall with the elbow joint. Monteggia fractures generally require surgery to stabilize the fracture and repair the joint, and can have a longer and more complex healing time, depending on the severity of the break.

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