Olecranon Fracture ORIF 24685

CPT Coding	Technique
Indications	Complications
Contraindications	Follow-up Care / Rehab Protocol
Alternatives	Outcomes
Pre-op Planning / Case Card	Review References

synonyms:olecranon fracture ORIF, elbow fracture ORIF

Olecranon Fracture ORIF CPT

Olecranon Fracture ORIF Anatomy

Olecranon Fracture ORIF Indications

Olecranon Fracture ORIF Contraindications

Olecranon Fracture ORIF Alternatives

Olecranon Fracture ORIF Pre-op Planning

Consider using pre-countoured plates
For fractures with comminution, radiocapitellar or transolecranon instability, articular marginal impaction should be treated with Plate fixation.
Consider a tension band wire construct for simple fracture patterns without comminution.
Consider excision and triceps advancement in elderly, low-demand patients with small unreconstructable fracture patterns without associated elbow instability.

Olecranon Fracture ORIF Technique

Sign operative site.
Pre-operative antibiotics, +/- regional block.
General endotracheal anesthesia
position. All bony prominences well padded.
Examination under anesthesia.
Prep and drape in standard sterile fashion.
Midline posterior incision curved around the olecranon.
Fracture opened and hematoma debrided.
Anatomic reduction with large tenaculum clamp. Consider drill hole in dorsal ulna to provide anchor point for clamp.
Place two parallel 0.062 or 0.045 k-wires obliquely from proximal ulna, across fracture site and into the anterior ulnar cortex. Back them up 5mm to allow later impaction.
Place 2.5mm drill hole transversely across triangular ulna diaphysis distal to the fracture and anterior enough to be bicortical.
Place one 18-gauge wire or two 22-gauge wires (using two tranvserse distal drill holes) in figure-8 fashion through transverse hole and under the triceps insertion and k-wires proximally.
Tighed the wires both medially and laterally. Trim twisted ends and bend into the adjacent soft tissue.
Bend k-wires and cut excess.
Incise triceps and impact bent ends into the proximal ulna with bone tamp.
Irrigate.
Close in layers.

Olecranon Fracture ORIF Complications

Olecranon Fracture ORIF Follw-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.

Olecranon Fracture ORIF Outcomes

Olecranon Fracture ORIF Review References