BACKGROUND: Isolated fracture of the distal one third of the ulna (the "nightstick fracture") is a common injury no clear consensus on its optimal management. The purpose of this study is to compare the clinical outcomes of operatively and non-operatively treated distal ulna fractures. METHODS: Patients treated over a 5-year period at a level I trauma center for distal ulna fracture were identified and medical records were analyzed. Data were collected on demographics, injury mechanism, fracture pattern, type of treatment, estimated time to osseous healing, and complications. Estimated bony healing time was analyzed with the t test, and treatment types were analyzed with the chi-square test. RESULTS: Forty-seven patients with 48 ulna fractures met inclusion criteria for the study. Mean follow-up was 36 weeks. One third of the group was female and mean patient age was 43 years. Eighteen ulnas were treated operatively. There was not a significant difference in the non-operative and operative groups regarding proportions of patients with angulation greater than 15° or 25% or greater translation. There was no significant difference in time to bony consolidation. The operative group had more complications, but the rate was not significantly different than the non-operative group. CONCLUSIONS: Isolated distal ulna fractures, including those angulated greater than 15° or translated more than 25%, appear to heal well with non-operative treatment. Operative treatment of closed isolated distal ulna fractures does not appear to confer a treatment advantage when compared to non-operative treatment.
BACKGROUND: Isolated fracture of the distal one third of the ulna (the "nightstick fracture") is a common injury no clear consensus on its optimal management. The purpose of this study is to compare the clinical outcomes of operatively and non-operatively treated distal ulna fractures. METHODS:Patients treated over a 5-year period at a level I trauma center for distal ulna fracture were identified and medical records were analyzed. Data were collected on demographics, injury mechanism, fracture pattern, type of treatment, estimated time to osseous healing, and complications. Estimated bony healing time was analyzed with the t test, and treatment types were analyzed with the chi-square test. RESULTS: Forty-seven patients with 48 ulna fractures met inclusion criteria for the study. Mean follow-up was 36 weeks. One third of the group was female and mean patient age was 43 years. Eighteen ulnas were treated operatively. There was not a significant difference in the non-operative and operative groups regarding proportions of patients with angulation greater than 15° or 25% or greater translation. There was no significant difference in time to bony consolidation. The operative group had more complications, but the rate was not significantly different than the non-operative group. CONCLUSIONS: Isolated distal ulna fractures, including those angulated greater than 15° or translated more than 25%, appear to heal well with non-operative treatment. Operative treatment of closed isolated distal ulna fractures does not appear to confer a treatment advantage when compared to non-operative treatment.