By Jim Thomas

Linebacker Pisa Tinoisamoa is down to no healthy arms. First came a dislocated left elbow. Then a broken left hand. Next was a sprained right shoulder. And on Monday, midway through the first quarter against Chicago, Tinoisamoa suffered a fractured right hand.

"It's really a similar fracture to the one in his other hand," coach Scott Linehan said. "I think it might even be the same bone. I don't know what the odds of that happening are."

Tinoisamoa was replaced by veteran Dexter Coakley at outside linebacker against the Bears. Tinoisamoa did not return.

Tinoisamoa's string of injuries began with the elbow injury in Week 2 at San Francisco. Interestingly, Monday's game against Chicago marked the first time since that injury that Tinoisamoa did not have the elbow wrapped or fitted for a brace.

Coakley made what appeared to be a momentum-changing play when he and defensive end Leonard Little converged on Chicago quarterback Rex Grossman with less than two minutes to go in the second quarter. Coakley jarred the ball loose and safety Oshiomogho Atogwe recovered for the Rams at the Bears' 28 with 1:39 to play in the half.

Coaches cannot make instant replay challenges in the final 2 minutes of each half, but a booth review ruled the play an incomplete pass and Chicago maintained possession.

Injury update

The Rams' best pass rusher, Little, left the game for good in the second half after absorbing a blow to his throat.

"He tried to go, but his throat started to swell," Linehan said. "I really can't tell you what the prognosis is right now."

Bears offensive tackle John Tait left the game on Chicago's second offensive series with an ankle injury but returned later in the half.

Bruce moves up

Wide receiver Isaac Bruce moved up to the No. 8 spot on the NFL's career list for reception yards. Bruce passed Hall of Famer Steve Largent with a 24-yard catch in the second quarter. That reception gave Bruce 13,098 yards; Largent had 13,089.

Vasher is inactive

Cornerback Nathan Vasher (hamstring) was among the pregame inactives for Chicago, meaning three Bears defenders who played in the Pro Bowl last season were out with injuries. Defensive tackle Tommie Harris may miss the rest of the season with a severe hamstring injury, and strong safety Mike Brown is on injured reserve with a foot injury.

The Bears were down to their third strong safety Monday because Brown's replacement, Todd Johnson, was a pregame scratch with a sprained ankle.

Adeyanju sits

As expected, DE Victor Adeyanju was a pregame inactive with a fractured forearm. Adeyanju had hoped to play against the Bears, his hometown team, but it was simply too soon after the original injury, which occurred Nov. 26 against San Francisco.

Other inactives for St. Louis: S Jerome Carter (ankle), LB Isaiah Kacyvenski (concussion), LB Jon Alston, TE Dominique Byrd, OT Jeremy Parquet, and C-G Larry Turner.

Quick recovery

Umpire Jim Quirk suffered a cut behind his right ear during a first-quarter punt return by Chicago. He was patched up by Rams athletic trainer Jim Anderson and didn't miss a pla