Ulnar bone fracture medical therapy: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
(3 intermediate revisions by the same user not shown)
Line 8: Line 8:
==Non-surgical therapy==
==Non-surgical therapy==
* The first step in managing a patient with a fracture is to stabilize the patient if he/she is unstable due to blood loss, etc by giving them intravenous fluids and giving them some painkillers if the pain is severe.
* The first step in managing a patient with a fracture is to stabilize the patient if he/she is unstable due to blood loss, etc by giving them intravenous fluids and giving them some painkillers if the pain is severe.
* In children, the usual plan is to attempt closed reduction followed by cast immobilization. In adults, treatment with immobilization in a molded long arm cast can be used in those rare occasions of a non-displaced fracture of both bones of the forearm. If the fracture shifts in position, it may require surgery to put the bones back together.
* In children, the usual plan is to attempt closed reduction followed by cast immobilization. In adults, treatment with immobilization in a molded long arm cast can be used in those rare occasions of a non-displaced fracture of both bones of the forearm. If the fracture shifts in position, it may require surgery to put the bones back together<ref name="pmid27454628">{{cite journal |vauthors=Kim JK, Kim JO, Koh YD |title=Management of Distal Ulnar Fracture Combined with Distal Radius Fracture |journal=J Hand Surg Asian Pac Vol |volume=21 |issue=2 |pages=155–60 |date=June 2016 |pmid=27454628 |doi=10.1142/S2424835516400075 |url=}}</ref>.
 
* Rigid immobilization is suggested in preference to removable splints in nonoperative treatment for the management of ulnar bone fractures.
* For all patients with ulnar bone fractures, a post-reduction true lateral [[Radiography|radiograph]] is suggested .
* Operative fixation is suggested in preference to [[Orthopedic cast|cast]] fixation for fractures with post-reduction radial [[shortening]] greater than 3 mm, dorsal tilt greater than 10º, or intra-articular displacement or step-off greater than 2 mm.
* Patients probably do not need to begin early wrist motion routinely after stable [[Bone fracture|fracture]] fixation.
* Adjuvant treatment of ulnar bone fractures with vitamin C is suggested for the prevention of disproportionate [[pain]].
*
 
== Complications of Non-surgical therapy ==
Failure of non-surgical therapy is common<ref name="pmid28988738">{{cite journal |vauthors=Alfaraj DN, Vilke GM |title=Tripartite Fracture of the Ulnar Sesamoid Bone of the Thumb |journal=J Emerg Med |volume=53 |issue=5 |pages=758–759 |date=November 2017 |pmid=28988738 |doi=10.1016/j.jemermed.2017.08.020 |url=}}</ref>:
* Re-displacement to its original position even in a cast
* [[Stiffness]]
* Post traumatic [[osteoarthritis]] leading to wrist pain and loss of function
* Other risks specific to cast treatment include:
** Compression of the swollen arm causing [[compartment syndrome]] or [[carpal tunnel syndrome]]
** [[Reflex sympathetic dystrophy]] is a serious complication
** Stiffness is universal following a prolonged period of immobilization and swelling


==References==
==References==
<references />
<references />

Latest revision as of 00:32, 17 January 2019

Ulnar bone fracture Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ulnar bone fracture from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Ulnar bone fracture medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ulnar bone fracture medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ulnar bone fracture medical therapy

CDC on Ulnar bone fracture medical therapy

Ulnar bone fracture medical therapy in the news

Blogs on Ulnar bone fracture medical therapy

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Ulnar bone fracture medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;

Overview

The first step in managing a patient with a fracture is to stabilize the patient if he/she is unstable due to blood loss, etc by giving them intravenous fluids and giving them some painkillers if the pain is severe. If only one bone is broken, using cast or brace might be a possible treatment option.

Non-surgical therapy

  • The first step in managing a patient with a fracture is to stabilize the patient if he/she is unstable due to blood loss, etc by giving them intravenous fluids and giving them some painkillers if the pain is severe.
  • In children, the usual plan is to attempt closed reduction followed by cast immobilization. In adults, treatment with immobilization in a molded long arm cast can be used in those rare occasions of a non-displaced fracture of both bones of the forearm. If the fracture shifts in position, it may require surgery to put the bones back together[1].
  • Rigid immobilization is suggested in preference to removable splints in nonoperative treatment for the management of ulnar bone fractures.
  • For all patients with ulnar bone fractures, a post-reduction true lateral radiograph is suggested .
  • Operative fixation is suggested in preference to cast fixation for fractures with post-reduction radial shortening greater than 3 mm, dorsal tilt greater than 10º, or intra-articular displacement or step-off greater than 2 mm.
  • Patients probably do not need to begin early wrist motion routinely after stable fracture fixation.
  • Adjuvant treatment of ulnar bone fractures with vitamin C is suggested for the prevention of disproportionate pain.

Complications of Non-surgical therapy

Failure of non-surgical therapy is common[2]:

References

  1. Kim JK, Kim JO, Koh YD (June 2016). "Management of Distal Ulnar Fracture Combined with Distal Radius Fracture". J Hand Surg Asian Pac Vol. 21 (2): 155–60. doi:10.1142/S2424835516400075. PMID 27454628.
  2. Alfaraj DN, Vilke GM (November 2017). "Tripartite Fracture of the Ulnar Sesamoid Bone of the Thumb". J Emerg Med. 53 (5): 758–759. doi:10.1016/j.jemermed.2017.08.020. PMID 28988738.