Ulnar bone fracture physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].
Overview
The Nondisplaced diaphyseal fractures of the shafts of ulna is rare, and its deformity is often obvious, with the patient supporting the deformed and injured limb with the other hand. Also, the orthopedic surgeon should consider a careful neurological evaluation of the motor and sensory functions of the radial, median, and ulnar nerves. The Ulnar Bone Fractures might be very painful, causing difficulties in moving the arm or elbow.
Ulnar Bone Fracture Physical Exam
The related signs and symptoms include[1][2]:
- Edema of the forearm
- Most of the time the edema will be a non-pitting edema
- Depends on the edema extent, it may even lead to compartment syndrome in the anterior and internal compartment of forearm
- Bruising
- As a manifestation of internal injury to the local vessels by trauma or fractures bone
- Decrease in range of motion
- Movement of the fractures limb will be painful if possible at all
- Tenderness
- Deformity
- Fractured bone deformity may be touchable in the internal side of the forearm if the fracture is displaced
In the physical exam the orthopedic surgeon should check the vascular status and amount of swelling in the forearm. In polytrauma patients or in comatose or obtunded patients a tense compartment with neurological signs or stretch pain should be considered as the compartment syndrome, and the compartment pressures should be measured and monitored.
Physical examination of patients with Ulnar bone fracture is usually remarkable for swelling, tenderness, bruises, ecchymosis, deformity and restricted range of motion of the wrist.
Appearance of the Patient
- Patients with Ulnar bone fracture usually appears normal unless the patients had a high energy trauma causing the open wound fracture.
Vital Signs
- Weak pulse may be seen when associated with polytrauma.
- Low blood pressure with normal pulse pressure may be present due to compound fracture with blood loss.
Skin
- Skin examination of patients with Ulnar bone fracture includes:
HEENT
- HEENT examination of patients with Ulnar bone fracture is usually normal.
Neck
- Neck examination of patients with Ulnar bone fracture is normal.
Lungs
- Pulmonary examination of patients with Ulnar bone fracture is usually normal.
Heart
- Cardiovascular examination of patients with Ulnar bone fracture is usually normal.
Abdomen
- Abdominal examination of patients with Ulnar bone fracture is usually normal.
Back
- Back examination of patients with Ulnar bone fracture is usually normal.
Genitourinary
- Genitourinary examination of patients with Ulnar bone fracture is usually normal.
Neuromuscular
- Neuromuscular examination of patients with Ulnar bone fracture is usually normal.
- However, some patients may develop neuropraxia of the branch of the Ulnar nerve resulting in decreased sensation of thumb, index and middle finger.
References
- ↑ He HY, Zhang JZ, Wang XW, Liu Z (September 2018). "[Acumed intramedullary nail for the treatment of adult diaphyseal both-bone forearm fractures]". Zhongguo Gu Shang (in Chinese). 31 (9): 803–807. doi:10.3969/j.issn.1003-0034.2018.09.005. PMID 30332871.
- ↑ Casagrande DJ, Morris RP, Carayannopoulos NL, Buford WL (December 2016). "Relationship Between Ulnar Variance, Cortical Bone Density, and Load to Failure in the Distal Radius at the Typical Site of Fracture Initiation". J Hand Surg Am. 41 (12): e461–e468. doi:10.1016/j.jhsa.2016.08.021. PMID 27707565.