Journal of Urgent Care Medicine

Urgent Care Diagnosis and Management of Midshaft Ulnar (Nightstick) Fractures

Urgent Message: Fractures of the midshaft ulna, commonly referred to as “nightstick fractures,” typically occur after direct injury to a forearm outstretched above the head as a protective mechanism. Evaluation includes inquiry into the circumstances of the assault, assessment for any other areas of trauma, examination of the skin, wrist and elbow joints, and radiography of the forearm. Management of closed, nondisplaced midshaft ulnar fractures centers around splint immobilization and arrangement of appropriate follow-up. Chandrika …

Elbow Pain and Swelling After a Fall

Case A 28-year-old woman presents to urgent care with elbow pain and swelling following a mechanical fall. She reports the pain is worse with range of motion. There is no shoulder or wrist pain, and no paresthesias. Exam confirms pain with palpation and decreased range of motion. The radial pulse is 2+; sensation distal to the elbow is grossly intact. The patient is afebrile, has a pulse of 104, respirations 20, and BP 124/80. View …

Forearm Pain in a 12-Year-Old Patient After a Fall

A 12-year-old girl presents to an urgent care center with pain in her right forearm. She reports that the pain started the previous evening when she tripped on a toy left out by her 2-year-old brother. The pain is worse with range of motion. She says she does not have any numbness. She has no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.