The ulna is the medial forearm bone forming the primary articulation with the humerus at the elbow via its olecranon and trochlear notch, providing the bony basis of elbow flexion and extension while the radius rotates around it.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Primary diaphyseal centre with secondary centres at olecranon (age 10) and distal styloid (variable). |
The posterior ulnar border is subcutaneous throughout its length, palpable from olecranon to styloid. Olecranon fractures from direct blows require fixation to restore the triceps mechanism. Monteggia fractures (proximal ulna fracture + radial head dislocation) are frequently missed if the radial head dislocation is not sought. Nightstick fractures (isolated ulnar shaft fracture) from direct blows to the forearm are managed conservatively. The ulnar styloid is fractured in most distal radius fractures but rarely requires separate fixation.
A fall onto the point of the elbow fractures the olecranon; displaced fractures disrupt the triceps mechanism and need fixation.
An isolated ulnar shaft fracture caused by a direct blow when the forearm is raised to protect the head.
A proximal ulnar shaft fracture with dislocation of the radial head, which is easily missed.
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