An ulnar fracture is a break in the ulna, one of the bones of the forearm. This type of fracture can be seen in people of all ages, and it is typically caused by a direct impact to the ulna, such as that which might be sustained in a fall or a physical argument. The symptoms of are very distinctive: the patient usually experiences extreme pain and a limited range of motion, and in the case of an open fracture, the 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. Standalone fractures of either bone are usually caused by impacts, while twisting of the forearm or bending the arm out of its normal range of motion will cause a both bone forearm fracture which involves the radius and the ulna. This type of fracture often takes the form of a spiral fracture, and it 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 it can be necessary to make certain lifestyle adjustments to protect the fractured bone while it heals. For example, a patient in a cast usually cannot engage in 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 put in a cast to keep it immobilized while it heals. Once the ulnar fracture heals, the pins may be removed or left in place, depending on the situation and the preferences of the patient. Complications of surgical stabilization can 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 sharp impact, as for instance when someone breaks a fall with the elbow joint. Monteggia fractures usually require surgery to stabilize the fracture and repair the joint, and they can have a longer and more complex healing time, depending on how severe the break is.