The ulna is one of the two long bones in the forearm, extending from the elbow to the wrist on the little finger side. It runs parallel to the radius, the forearm’s other long bone. A fracture is a break or crack in a bone, occurring when force exceeds its structural capacity.
Understanding the Ulna and its Fractures
The ulna provides stability and enables a wide range of arm, wrist, and hand movements. It is slightly longer than the radius and plays a central role in forming both the elbow joint with the humerus and the wrist joint with the radius and carpal bones. Its unique structure, with a broad proximal end at the elbow and narrower distal end at the wrist, contributes to the arm’s ability to bend, straighten, and rotate.
An ulnar fracture specifically involves a break in this bone. These fractures vary from a small crack (hairline fracture) to a complete break where the bone separates into two or more pieces. Severity depends on the force of impact and the break’s location. Some fractures are simple, with the bone remaining aligned, while others involve displaced fragments.
Signs, Symptoms, and Causes of Ulnar Fractures
Individuals often experience sudden, intense pain immediately following the injury. This pain is typically accompanied by swelling and bruising around the affected area, and the skin may feel warm to the touch. A noticeable forearm deformity, such as an unnatural bend or angulation, can also indicate a fracture.
Moving the injured arm or wrist becomes difficult and painful. In some cases, the individual may be unable to bear weight or apply pressure with the affected limb. Tenderness to the touch directly over the ulna is another common symptom.
Ulnar fractures typically result from significant force applied to the forearm. Common mechanisms include direct impact, such as during a fall onto a hard surface or a sports collision. Falling onto an outstretched hand, where force transmits up the arm, can also cause an ulnar fracture.
Diagnosing an Ulnar Fracture
Diagnosis begins with a physical examination. The doctor carefully examines the injured arm for swelling, bruising, and visible deformities. They also check for tenderness by pressing on the ulna and assess range of motion in the elbow and wrist, noting any pain or limitations.
Imaging tests confirm the fracture’s presence and nature. X-rays are the primary diagnostic tool, providing clear images to identify the break and determine its alignment. For complex fractures or concerns about soft tissue damage, a computed tomography (CT) scan may provide a more detailed view.
Treatment Approaches for Ulnar Fractures
Treatment aims to realign bone fragments and immobilize them for proper healing. The choice between non-surgical and surgical approaches depends on the fracture type, severity, and whether the bone fragments are displaced.
Non-surgical treatment suits stable fractures where bone pieces remain aligned or are easily repositioned. This approach involves immobilizing the forearm with a cast, splint, or brace. Immobilization prevents movement at the fracture site, allowing the bone to mend over several weeks. Follow-up X-rays monitor healing progress and ensure alignment.
Surgical intervention is necessary for complex ulnar fractures, such as those severely displaced, involving multiple fragments, or extending into a joint. Open reduction and internal fixation (ORIF) is a common surgical technique. An incision is made to access the fractured bone. Fragments are realigned and held in place with metal hardware (plates, screws, or rods) to stabilize the fracture while it heals. The decision for surgery considers the patient’s age, activity level, and overall health to restore optimal function and prevent long-term complications.
Recovery and Rehabilitation After an Ulnar Fracture
Recovery involves bone healing and restoring strength and mobility. Bone healing takes several weeks to a few months, varying by severity and individual factors. During this time, the body forms new bone tissue to bridge the break, strengthening the union.
Once immobilization is complete and the bone shows signs of healing, physical therapy and rehabilitation exercises are a key part of recovery. These exercises restore full range of motion in the elbow and wrist, improve muscle strength, and enhance overall arm function. Adherence to the prescribed program helps regain pre-injury capabilities. Patients may experience temporary limitations in daily activities, such as lifting heavy objects or participating in certain sports, as the arm heals and regains strength.