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Fracture of the Ulnar Bone

Last updated Sept. 14, 2018

Approved by: Maulik P. Purohit MD, MPH

stockdevil - FreeDigitalPhotos.net

X-ray showing a fracture of the forearm (Ulnar and Radius). It was operated and internal fixed by plate and screw.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Broken Ulnar Bone Fracture
  • Forearm Ulnar Bone Fracture
  • Fracture of the Ulna

What is Fracture of the Ulnar Bone? (Definition/Background Information)

  • The forearm (between the wrist and elbow) consists of two bones - radius and ulna; the radius is the larger of the two bones
  • A Fracture of the Ulnar Bone is a break or crack, in the longer of the two forearm bones, called the ulna
  • A high percentage of adults who sustain forearm fractures, do so in the radius, near the wrist or at the bone shaft, which is considered the middle of the forearm (between the wrist and elbow). However, both bones, the radius and ulna may be injured
  • Treatment of the Ulnar Bone Fracture is dependent upon the type of fracture. The prognosis is linked to the severity and type of fracture, but is generally good with proper treatment 

There are several different types of Ulnar Fractures, some of which are categorized based on the injury impact force. The fracture types include:

  • Open fracture: In this type of fracture, the bone breaks and pierces the skin, requiring immediate medical treatment. Apart from this, ligament, muscle, and tendon damage, may also occur
  • Closed fracture: In this type, the bones do not pierce the skin. However, injury to the soft tissues under the skin, may occur
  • Displaced fracture: In this type of fracture, the bone may fragment around the point of breakage and get misaligned; hence, surgery is usually required
  • Comminuted fracture: In a comminuted fracture, the bone is broken into three or more pieces. It is considered one of the most unstable type of fracture
  • Greenstick fracture: A greenstick fracture means that the bone is cracked, but not broken all the way through
  • Buckle (or torus) fracture: A buckle fracture, also known as a torus fracture, occurs when one side of the bone is compressed or buckled, without fracturing the other side
  • Metaphyseal fracture: With this type, the fracture injury is confined to the upper/lower part of the shaft, but does not affect the growth plate
  • Galeazzi fracture: A fracture that extends through an area of the bone, causing the bone to bend on the other side
  • Monteggia fracture: A fracture type that affects both sides of the forearm. This is a severe injury requiring immediate medical treatment 

Who gets Fracture of the Ulnar Bone? (Age and Sex Distribution)

  • Fractures of the Ulnar Bone may occur in individuals of any age, race, ethnic group, and gender
  • Individuals participating in high-risk physical activities (such as certain sports) are at an increased risk 

What are the Risk Factors for Fracture of the Ulnar Bone? (Predisposing Factors)

Common risk factors associated with an Ulna Fracture include:

  • Participation in high-risk contact sports, such as football and hockey
  • Accidents causing injury to the forearm
  • An advanced age (elderly adults are higher prone to such fractures)
  • Reduced bone density (osteoporosis) 

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Fracture of the Ulnar Bone? (Etiology)

Causal factors of an Ulnar Bone Fracture could include:

  • Direct trauma to the arm/forearm, due to an automobile accident
  • Taking part in any rough or high-impact sport
  • Falling from a significant height; especially landing on one’s arm (or the fracture occurring since the individual is overweight)
  • Street fights, gunshot wounds, and domestic violence, may also cause a Fracture of the Ulnar Bone 

What are the Signs and Symptoms of Fracture of the Ulnar Bone?

Ulnar Bone Fractures may be very painful, making it difficult to move the arm or elbow. The signs and symptoms include:

  • Severe pain at the site, where the injury occurred
  • Signs of bruising, swelling of the forearm
  • Stiffness or inability to move the arm, wrist, or elbow
  • Tenderness to touch
  • In some rare cases, the pieces of bone may protrude through the skin 

How is Fracture of the Ulnar Bone Diagnosed?

Diagnostic methods that a physician may use to help diagnose Forearm Ulnar Bone Fractures include:

  • Physical examination: A thorough physical examination is important in identifying any noticeable deformities, swelling, contusions, within the forearm. Individuals are also expected to provide an explanation of the circumstances that caused the injury. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
  • X-ray of the forearm: X-rays are the most common method in evaluating a fracture, and if the bone has been displaced. This diagnostic test helps provide a clear image of the bone, identify the exact location of the injury, and determine the extent of the fracture 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Fracture of the Ulnar Bone?

Complications associated with Ulnar Shaft Fractures include:

  • Damage to the nerves or blood vessels of the forearm
  • Abnormal pressure build-up within the muscles of the arm/elbow that reduces blood flow, preventing oxygen and nourishment from reaching the nerve and muscle cells (termed as forearm compartment syndrome)
  • The immobilization required to heal forearm fractures may occasionally result in painful shoulder inflammation, stiffness, and reduced range of motion (frozen shoulder)
  • Malunion: A serious complication that might occur, if the ulnar bone in the forearm heals in an improper position
  • Nonunion: Another serious complication, when the ulnar bone does not heal adequately, shifts to an improper position, receives an inefficient supply of blood flow, or becomes infected
  • Osteoporosis: A disease that causes bones to weaken and become more brittle
  • Infection of the bone (osteomyelitis)
  • Reflex sympathetic dystrophy syndrome: A disorder associated with the sympathetic nervous system (a part of the autonomic nervous system) is a rare complication 

How is Fracture of the Ulnar Bone Treated?

The goals of forearm fracture treatments are to realign the bone, encourage rapid recovery, and help the individual to resume regular/daily activities, as early as possible. The treatments associated with a Broken Ulnar Bone Fracture include both nonsurgical and surgical methods. 

The nonsurgical treatment methods for Ulnar Bone Fractures include:

  • Complete immobilization of the forearm with a splint or cast, may be required to restrict movement
  • Applying ice to the arm/elbow can help reduce pain and swelling
  • Individuals are likely to need physical therapy exercises after the cast is removed. The goals of these exercises are to strengthen the forearm muscles, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy program and regain full strength and functionality 

The surgical treatment methods for Ulnar Bone Fractures include:

  • Closed reduction of Ulnar Fracture: Closed reduction is a surgical method that involves realigning the bone back to its original position, without making an incision at the fracture site. This procedure is usually performed under local anesthesia
  • Open reduction and internal fixation (ORIF) of Ulnar Fracture: Open reduction is a surgical procedure to realign the fractured bone, to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin 

How can Fracture of the Ulnar Bone be Prevented?

To prevent Fractures of the Ulna, individuals should be careful and consciously aware, while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must be provided a safe environment to work, study, or play. Any possible dangers should also be anticipated and appropriate safety measures adopted. 

A few ways to further help prevent unwanted injuries or an Ulnar Bone Fracture include:

  • Individuals, who participate in any high-risk sports, should wear appropriate safety equipment to help prevent the possibility of such fractures
  • Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium-intake is recommended, even after a fracture. For women, the recommended amount of calcium, increases with age and menopause
  • Perform weight-bearing exercises to strengthen bones 

What is the Prognosis of Fracture of the Ulnar Bone? (Outcomes/Resolutions)

  • The prognosis of the condition depends on the type and severity of the fracture
  • A majority of the Fractures of the Ulnar Bone heal without any serious complications. The individuals may return to sports or normal daily activities, when advised by their physician. In such individuals, the outcome is generally excellent
  • When properly treated and rehabilitated, a high percentage of individuals regain their full strength and range of motion in the injured forearm 

Additional and Relevant Useful Information for Fracture of the Ulnar Bone:

In a 4-5 months old infant, the ulna bone is 50% larger in diameter than the radius. As an adult, when the bones have matured and stopped growing, the ulna is half (in size) that of the radius.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 4, 2014
Last updated: Sept. 14, 2018