Nightstick Fractures, Outcomes of Operative and Non-Operative Treatment.

INTRODUCTION

A nightstick fracture is an isolated fracture of the ulnar shaft. Although operative and non-operative treatments have been commonly decided by the degree of displacement of the fracture, still there is a controversy specially in those moderately displaced. Herein we report our experience with nightstick fractures.

OBJECTIVE

To evaluate operative and non-operative treatment of nightstick fracture.

MATERIALS AND

METHODS

We retrospectively reviewed the clinical notes, physiotherapy letters and radiographs of 52 patients with isolated ulnar shaft fractures. Outcome Measurements included radiographic healing, post-operative range of motion and complications.

RESULTS

The study included 13 females and 39 males, with a mean age of 26 years [range, 18-93 years]. The mean Follow-up period was 32 months ranged from 12 to 54 months. Ten patients were treated non-operatively; forty-two patients had open reduction and internal fixation including six open fractures. The average wait for surgery was 2.5 days. Mobilisation was commenced immediately after the surgeries non-load bearing. 40 patients had no complications post-operatively with good outcome and average of four visits follow-up. In the non-operative group, five out ten failed and had a mean follow-up of nine visits.

CONCLUSION

Satisfactory outcome is to be expected with open reduction and internal fixation. Fractures with less than 50% displacement should be treated on individual bases, considering; age, pre-morbid functional status, co-morbidities, compliance and associated injuries.