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An ulnar fracture occurs when the ulna, which is a bone in the forearm, is cracked as the result of an impact, twist, or other application of force. The treatment for an ulnar fracture will vary according to the severity and type of fracture, as well as the age and overall health of the patient. Immediate first aid for such an injury will include the RICE treatment, or rest, ice, compression, and elevation, though if bleeding is occurring simultaneously with the fracture, this should be taken care of first.
Smaller fractures, sometimes known as hairline fractures, can sometimes be treated exclusively with the RICE treatment. Very small ulnar fracture injuries may heal on their own given enough time and rest, but the patient will need to be careful to immobilize the injury as much as possible during the healing process. This can be done with the application of a cast, though a sling may be sufficient to keep the arm immobile if the ulnar fracture is small enough. Larger fractures will require immobilization using a hard cast that will prevent any movement of the forearm as well as re-injury from accidental impacts.
If the fracture is severe, the bone will need to be repaired surgically. This is especially true if the bone breaks through the skin, as bleeding and damage to soft tissue will need to be addressed. Any damage to nerves and surrounding soft tissues will need to be repaired if possible, and the bone will need to be stabilized using pins and screws. These injuries tend to be quite painful, and recovery time can be extensive. The patient will lose range of motion as well as strength in the affected arm, so physical therapy will be necessary after sufficient healing time has been granted to the injury.
A Monteggia fracture is a type of ulnar fracture in which the ulna may also dislocate. The dislocation will need to be addressed, usually surgically, in addition to the break in the bone. Recovery time for this injury is perhaps the most protracted, and the arm will need to be immobilized for an extended period of time. A Monteggia fracture is often the result of a fall, during which the patient landed on the elbow, thereby forcing the bone out of its normal position. Ligaments are likely to be damaged when this injury occurs, and recovery will involve re-strengthening the ligaments.