Ulna

From Wikipedia, the free encyclopedia

Bone: Ulna

Upper extremity

Shown is the right hand, palm down (left) and palm up (right). Ulna is #2

Gray's

subject #52 214

MeSH

Ulna

The ulna is one of the two long bones in the forearm, the other being the radius. It isprismatic in form and runs parallel to the radius, which is shorter and smaller. In anatomical position (i.e. when the arms are down at the sides of the body and the palms of the hands face forward) the ulna is located at the side of the forearm closest to the body (the medialside), the side of the little finger.
Contents
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1 Articulations 2 Proximal and distal aspects 3 Structure 4 Muscle attachments 5 Fracture 6 In other animals 7 Gallery

8 See also 9 References 10 External links

[edit]Articulations
The ulna articulates with:

trochlea of the humerus, at the right side elbow as a hinge joint with semilunar trochlear notch of the ulna. the radius, near the elbow as a pivot joint, this allows the radius to cross over the ulna inpronation. the distal radius, where it fits into the ulna notch. the radius along its length via the interosseous membrane that forms a syndesmoses joint it is also called the poisidion

[edit]Proximal

and distal aspects

The ulna is broader proximally, and narrower distally. Proximally, the ulna has a bony process, the olecranon process, a hook-like structure that fits into the olecranon fossa of the humerus. This prevents hyperextension and forms a hinge joint with the trochlea of the humerus. There is also a radial notch for the head of the radius, and the ulnar tuberosity to which muscles attach. At the distal end of the ulna is a styloid process.

[edit]Structure
The long, narrow medullary cavity is enclosed in a strong wall of compact tissue which is thickest along the interosseous border and dorsal surface. At the extremities the compact layer thins. The compact layer is continued onto the back of the olecranon as a plate of close spongy bone with lamell parallel. From the inner surface of this plate and the compact layer below it trabecul arch forward toward the olecranon and coronoid and cross other trabecul, passing backward over the medullary cavity from the upper part of the shaft below the coronoid. Below the coronoid process there is a small area of compact bone from which trabecul curve upward to end obliquely to the surface of the semilunar notch which is coated with a thin layer of compact bone. The trabecul at the lower end have a more longitudinal direction. http://www.innerbody.com/image_skelfov/skel21_new.html

Monteggia fracture
From Wikipedia, the free encyclopedia

Monteggia Fracture-Dislocation

Classification and external resources

X-ray of Monteggia fracture of right forearm

ICD-10

S52.0

ICD-9

813.03, 813.13

eMedicine

orthoped/201

MeSH

D009011

The Monteggia fracture is a fracture of the ulna that affects the joint with the radius. More precisely, it is a fracture of the proximal third of the ulna with dislocation of the head of the radius. It is named after Giovanni Battista Monteggia.[1][2]
Contents
[hide]

1 Causes 2 Classification (Bado type) 3 Management

4 Results 5 See also 6 References 7 External links

[edit]Causes
Mechanisms include:

Fall on an outstretched hand with the forearm in excessive pronation (hyper-pronation injury) Direct blow on back of upper forearm. In this context, Monteggia fractures are most commonly seen in defense against blunt trauma (e.g. nightstick injury).

[edit]Classification

(Bado type)

There are four types (depending upon displacement of the radial head)[3]:

I - Extension type (60%) - ulna shaft angulates anteriorly (extends) and radial head dislocates anteriorly. II - Flexion type (15%) - ulna shaft angulates posteriorly (flexes) and radial head dislocates posteriorly. III - Lateral type (20%) - ulna shaft angulates laterally (bent to outside) and radial head dislocates to the side.

IV - Combined type (5%) - ulna shaft and radial shaft are both fractured and radial head is dislocated, typically anteriorly.

[edit]Management
Monteggia fractures may be managed conservatively in children with closed reduction (resetting and casting), but due to high risk of displacement causing malunion, open reduction internal fixation is typically performed.[4]

[edit]Results
In children, the results of early treatment are quite good, typically normal or nearly so. If diagnosis is delayed, reconstructive type surgery is needed and complications are much more common and results poorer. In adults, the healing is slower and results usually not as good. Complications of ORIF surgery for Monteggia fractures can include non-union, malunion, nerve palsy and damage, muscle damage, arthritis,tendonitis, infection, stiffness and loss of range of motion, compartment syndrome, audible popping or snapping, deformity, and chronic painassociated with surgical hardware such as pins, screws, and plates. Several surgeries may be needed to correct this type of fracture as it is almost always a very complex fracture that requires a skilled orthopedic surgeon, usually a 'specialist', familiar with this type of injury.[5]