Nightstick Fracture

Introduction

A nightstick fracture is an isolated fracture of the ulna associated with a direct blow. Nightstick fracture is a descriptive colloquialism based on mechanism of injury.

Mechanism of Injury

<a class="external" href="http://www.istockphoto.com/file_closeup/lifestyle/adults/6284072-policeman-using-night-stick.php?id=6284072" rel="nofollow" target="_blank">http://www.istockphoto.com/file_closeup/lifestyle/adults/6284072-policeman-using-night-stick.php?id=6284072</a>

Here's the guy who is going to give you a nightstick fracture! When you defend yourself from an attacker wielding a stick (club, baseball bat, crowbar, trungeon, knobkerry etc) you tend to protect your head by bringing up an arm(s) with your thumb pointing towards you (radial aspect) and your ulna presented to block the oncoming bar. This is the mechanism of injury for nightstick fracture

Pathological Appearance

The nightstick fracture is usually described as an isolated fracture of the middle third of the ulna. This patient was attacked with a crowbar and has a typical nightstick fracture.

Treatment

<a class="external" href="http://www.jbjs.org.uk/cgi/reprint/66-B/3/408" rel="nofollow" target="_blank">I. W. D. DYMOND THE TREATMENT OF ISOLATED FRACTURES OF THE DISTALULNA THE JOURNAL OF BONE AND JOINT SURGERY, VOL. 66-B. No. 3, MAY 1984 pp408 - 410 </a>

This quotation is taken from a paper in which the authors reviewed the treatment of ulnar fractures. It is noteworthy that two views at 90 degrees are required to demonstrate the true degree of displacement of the fracture. Failure to demonstrate the true degree of fracture displacement could result in inappropriate treatment.