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Olecranon Fx

Olecranon Fracture

synonyms: elbow fracture, olecranon fx

Olecranon Fx ICD-9

  • 813.01(closed fracture of olecranon process of ulna)
  • 813.11(open fracture of olecranon process of ulna)

Olecranon Fx Etiology / Epidemiology / Natural History

  • Common causes: MVA, falls directly onto posterior elbow

Olecranon Fx Anatomy

Olecranon Fx Clinical Evaluation

Olecranon Fx Xray / Diagnositc Tests

  • A/P, lateral and oblique elbow films. Fracture is best visualized on lateral film.

Olecranon Fx Classification / Treatment

  • AO classification AO Classification old view
  • Nondisplaced: sling immobilization followed by gentle ROM initiated within 10 days. Consider initially long arm casting for 4 weeks or ORIF depending of patient and fracture severity. Initially weekly xrays indicated to ensure fracture remains reduced.
  • Displaced Young/high-demand: ORIF
  • Displaced Elderly/low-demand: ORIF vs excision with triceps advancement.
  • Stress Fracture: generally associated with throwning sports, baseball. Treatment: rest and temporary splinting. Consider electrical stimulation. ORIF indicated after failure of nonoperative treatment. (Ahmad CS, Clin Sports Med 2004;23:665).

Olecranon Fx Associated Injuries / Differential Diagnosis

Olecranon Fx Complications

  • Superficial wound infection
  • Contracture
  • Nonunion
  • Hardware failure
  • Malunion
  • Painful hardware: (tension band wiring frequently requires removal) (Karlsson MK, JSES 2002;11:377).
  • Ulnar nerve palsy

Olecranon Fx Follow-up Care

  • Post-op: Place in posterior splint in 50-70º of flexion. Encourage finger ROM.
  • 10-14 Days: Wound check, remove staples. Evaluate reduction on xrays. Place in long-arm cast or removable posterior splint depending on fracture type and strength of fixation.
  • 6 Weeks: Wound check, evaluate xrays for callus formation. Place in removable posterior splint and begin elbow ROM exercises.
  • 3 Months: Evaluate xrays for fracture union. Begin gentle sport specific exercises depending on fracture union. Consider bone stimulator if union not evident on xrays.
  • 6 Months: Evaluate xrays. Return to sport.
  • 1Yr: Evaluate xrays. Evaluate xrays using elbow outcome measures. May consider hardware removal if hardware is painful.
  • (Bailey CS, JOT 2001;15:542).
  • (Karlsson MK, CORR 2002;403:205).

    Olecranon Fx Review References

    Acumed Elbow Plate (T)

    Smith&Nephew Elbow

    Synthes Prox Ulna

    OlecraNail

    Zimmer Small Frag set

    Zimmer Periarticular

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