Ulnar Fractures of the wrist, Causes, Symptoms & Treatment

The forearm is made up of two bones, the bigger of the two bones is called the radius and is located on the inside of your wrist while the smaller of the two bones, located on the outside  of your wrist is called the ulnar. The ulnar extends from the elbow to the wrist. The ulnar can be fractured or broken anywhere along its  course. When it is broken at the wrist it is often called a ulnar styloid fracture.  Ulnar styloid fractures  usually occur from direct trauma such as in sports or a fall.  Isolated ulnar styloid fractures are relatively rare as often  the ulnar is fractured at the same time as the radius. Occasionally a ulnar styloid fracture can be associated with damage to the ligaments on the outside of the wrist resulting in a more serious injury.

Ulnar styloid fractures  commonly happen after a fall onto an outstretched hand. People with osteoporosis (decreased bone density) are at an increased risk if they fall. But even young athletes with strong bones are susceptible to ulnar styloid fractures if the impact is hard enough.

A ulnar styloid fracture is most common in these sports:

• Skiing
• Snowboarding
• Skateboarding or inline skating
• Bicycling
• Contact sports (e.g. football or hockey)

Ulnar styloid  fractures usually result in immediate pain on the outside the forearm and the  pinky side of the wrist. Common symptoms also include:

• Swelling and tenderness in wrist area
• Bruising (black and blue discoloration)
• Pain on the pinky side of the wrist

If the injury to your wrist is very painful, or your wrist doesn’t look right, you should go to the emergency department for immediate care. Seeking medical attention as soon as possible is important if you think you have a wrist fracture, especially if there is bleeding through the skin, you feel numbness, or your fingers lack pinkness. If you have less severe symptoms, schedule an appointment with your doctor for the next day.

After asking questions about your medical history and conducting a physical exam, your doctor will order x-rays of your wrist to confirm whether your wrist is fractured. Sometimes, additional imaging tests, such as a magnetic imaging test (MRI) will be necessary to see if there are injuries to the soft tissues around your wrist.

If the fractured bones are in proper alignment (non-displaced), or if your doctor can realign the broken bones in place, then a ulnar styloid fracture is treated without surgery. Conservative treatments typically involve:

• Immobilizing the wrist with a splint for the first few days after the injury
• Applying a cast once the swelling goes down
• Taking x-rays after the cast is applied to check the fracture alignment (the cast may be changed if it gets loose over the next four to six weeks)
• Physical therapy after the fracture has healed

Try these exercises to help address your condition:

Below is a PDF of the exercise program.

Ulnar Fractures of the Wrist

If the fractured ends of the ulnar cannot be aligned or there is additional injury to the ligaments of the wrist, then your doctor may recommend surgery. Your surgeon will advise on the best surgical options for you based on the type of ulnar styloid fracture you have. After the broken bone is  carefully aligned, your surgeon may hold it  in the correct position  by inserting pins, an external fixator, a plate and screws, or a combination of these options.

Most athletes will fully recover from a broken ulnar.  Patients may experience moderate pain for a few weeks after their injury and treatment. Recovery will vary depending on the treatment needed. Athletes may initially return to low impact sports, such as swimming or bicycling, after a month or two. You can expect to resume play after three to six months.