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
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