Diagnosis

Wedge fracture of the ulna

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Forearm fractures are often the result of indirect mechanisms, such as a fall onto an outstretched hand, sporting activities, etc. More details about their clinical and radiographic examination see here .

Usually, the wedge fragment in an ulnar fracture is small. However, it may involve significant cortical bone loss due to the limited circumference and thick cortices, with minimal medullary cavity. The wedge fragment is frequently avascular.

Options
1.  Intact wedge
2.  Fragmented wedge
3.  With dislocation of proximal radioulnar joint (Monteggia)

1.  Intact wedge

Fractures where the ulnar wedge is intact are classified as AO/OTA 2U2B2.

22-B1.1

22-B1.1

2.  Fragmented wedge

Fractures where the ulnar wedge is fragmented are classified as AO/OTA 2U2B3.

3.  With dislocation of proximal radioulnar joint (Monteggia)

Severe angulation and/or shortening of one of the forearm bones can be accompanied by fracture of the other bone or dislocation of a radioulnar joint.
In a Monteggia fracture-dislocation, the ulnar fracture is associated with a dislocation of the radial head, at the proximal radioulnar joint and the radiocapitellar joint.

These are classified by AO/OTA, according to the morphology of the ulnar fracture, with qualifier (m). For example, the illustration shows a 2U2B3(m).

In most such cases, the radial head dislocates anteriorly or laterally; rarely is the dislocation posterior.