Olecranon Fracture S52.023A 813.01

Olecranon Fracture xray

proximal ulna anatomy picture

olecranon fracture ORIF xray

synonyms: elbow fracture, olecranon Fracture 

Olecranon Fracture ICD-10

Olecranon Fracture ICD-9

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

Olecranon Fracture Etiology / Epidemiology / Natural History

  • Common causes: MVA, falls directly onto posterior elbow

Olecranon Fracture Anatomy

Olecranon Fracture Clinical Evaluation

  • Pain, swelling in elbow.
  • Document NV exam.
  • Document wrist evaluation.

Olecranon Fracture Xray / Diagnositc Tests

Olecranon Fracture Classification / Treatment

  • 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.
  • Olecranon 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).
  • Trans-olecranon fracture-dislocation: Treatment = ORIF.  (Mortazavi SM, Injury. 2006 Mar;37:284, Ring D, JOT. 1997;11:545)

Olecranon Fracture Associated Injuries / Differential Diagnosis

Olecranon Fracture Complications

  • Superficial wound infection
  • Contracture
  • Nonunion
  • Hardware failure
  • Malunion
  • Painful hardware: occurs in 50%-80% of patients after olecranon fracture fixation. (tension band wiring frequently requires removal) (Karlsson MK, JSES 2002;11:377).
  • Ulnar nerve palsy

Olecranon Fracture 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 removali f hardware is painful.
  • (Bailey CS, JOT 2001;15:542).
  • (Karlsson MK, CORR 2002;403:205).

Olecranon Fracture Review References