Nightstick fracture (ulna)

Nightstick fractures are isolated fractures of the ulna, typically transverse and located in the mid-diaphysis and usually resulting from a direct blow. It is a characteristic defensive fracture when the patient tries to ward off an overhead blow from an assailant (or local law enforcement officer) branding a bar-like weapon.

This is a defense type fracture and cases should prompt concern for a patients safety, it is rare that an isolated fracture of the ulnar can be the result of falling over, intimate partner violence amongst other things should be considered in patients where the clinical details do not match the fracture .

Treatment and prognosis

Although typically a closed fracture, they have a higher rate of delayed union or non-union.

History and etymology

Historically this fracture was seen not infrequently due to a strike from a policeman’s baton (known as a nightstick in the USA).