A prospective cohort study from Cook County Hospital comparing axilla-to-palm cast immobilization versus early mobilization with elastic wrap for isolated ulnar shaft (nightstick) fractures — asking whether prolonged immobilization is responsible for this fracture's notoriously slow healing and high non-union rate.
When you see a closed, minimally displaced isolated ulnar shaft fracture (nightstick mechanism, <50% displacement, angulation ≤10°), treat with an elastic wrap from palm to elbow and encourage early active use — not a long arm cast.
Reserve casting or operative fixation for completely displaced or highly comminuted fractures.
A prospective cohort study from Cook County Hospital comparing axilla-to-palm cast immobilization versus early mobilization with elastic wrap for isolated ulnar shaft (nightstick) fractures — asking whether prolonged immobilization is responsible for this fracture's notoriously slow healing and high non-union rate.
When you see a closed, minimally displaced isolated ulnar shaft fracture (nightstick mechanism, <50% displacement, angulation ≤10°), treat with an elastic wrap from palm to elbow and encourage early active use — not a long arm cast.
Reserve casting or operative fixation for completely displaced or highly comminuted fractures.