Issue 047
March 2009
What is it and how does it happen?
The ulna is one of the two bones that run from the elbow to the wrist. It forms the edge of the forearm that is in line with the little finger.
A break in the ulna alone (with no damage to other bones or joints) is referred to as a ‘nightstick fracture’, after the police implement that is frequently credited with causing this injury. In MMA, the most common way that this fracture occurs is from a heavy kick that is blocked by the forearm.
Sometimes damage to the ulna can be accompanied by damage to the other bone of the forearm, the radius. It may also be fractured, or it can be dislocated at either the wrist or the elbow. This can happen either from direct impact or from a fall onto an outstretched hand.
What does it feel like?
The forearm is likely to be painful and swollen, and occasionally the injury may be mistaken for severe bruising. If there is damage at, or near, the elbow there may also be pain when bending or twisting the arm. Occasionally there might be visible deformity of the arm.
Who has it happened to?
Randy Couture suffered a nightstick fracture in his win over Gabriel Gonzaga at UFC 74, when he blocked a high kick with his forearm. It wasn’t enough to prevent Couture from winning by third-round TKO.
K-1 fighter Jerome Le Banner was less fortunate when he suffered a similar injury against Ernesto Hoost in the final of the 2002 K-1 Grand Prix. Hoost then targeted Le Banner’s broken arm to force a stoppage win. With a more complicated break than Couture’s, Le Banner required surgery and a plate inserted in the arm. He has suffered from complications and difficulties with it ever since, most recently in his 2008 Grand Prix fight against Remy Bonjasky, which ended by doctor stoppage following an injury to the same arm. Le Banner protested the stoppage and claimed after the fight that the arm was not broken.
Frank Shamrock suffered an ulna fracture in his Strikeforce title fight against Cung Le in March this year, eventually losing by TKO due to the injury. He required five hours of surgery, a plate, and six screws. He has said that he plans to have the plate and screws removed before making a return to MMA.
Treatment
If you suspect a fracture then go to a hospital emergency department straight away. How it will be treated depends on how serious the injury is. If there is damage involving the elbow joint, or if the fracture is displaced (the broken ends of the bone have moved and aren’t together as they should be), then surgery may be needed and a metal plate inserted to hold the ends of bone in the correct position. The plate may or may not be removed once the bone has healed. If there is no displacement of the fracture then the arm is likely to be put in a cast, brace, or splint for a period of time.
How long can a fighter with this injury expect to be out for?
Around six to ten weeks for a simple, non-displaced fracture. Up to six months or even longer if surgery is required or there are complications.
What long-term problems is it likely to cause?
An athlete with a straightforward fracture that heals cleanly is unlikely to have too many problems. Athletes who require surgery are at a higher risk of complications. Incidentally, having a plate inserted may make the forearm more sensitive to future impacts. Getting the right treatment as early as possible is crucial, as a displaced fracture which is not set correctly may heal in a weakened position.
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