Produced by the implanted hardware, which can be removed after the fracture has The most frequent complication is irritating symptoms In most instances, olecranon fractures heal Therefore, with this pattern, more extensive fixation with a plate is required. Note how the associated coronoid process fracture creates joint instability. More recently, suture fixation techniques have been developed to avoid the hardware problems.įigure 4: A more comminuted fracture. This tensionīand construct changes the deforming tension force of the triceps into a compressiveįorce that favors healing, but the wires may be irritating and need to be removed in a subsequent procedure. Wire is then placed in a figure eight pattern to apply tension. Two parallel K wiresĪre inserted through the tip of the olecranon and across the fracture site. Olecranon fractures that are not comminuted (Figure 3). Tension band wiring works well for transverse Tension band wiring or plating are the two most common techniques Most displaced fractures require surgical Nondisplacedįractures heal well in most circumstances the most common complication is Thereafter, flexion is limited to 90ĭegrees until radiographic evidence shows fracture healing. Motion shouldīe started then to limit joint stiffness. If non-operative treatment is chosen, theĮlbow is immobilized between 45 to 90 degrees of flexion for 3 weeks. Nondisplaced fractures with an intact elbowĮxtensor mechanism can be treated non-operatively but these injuries must beĬlosely monitored with radiographs to ensure that they do not displace. Propensity to fall or both – and thus the presence of the injury itself may be Olecranon fractures may be sign of fragility – weak bones or a Subsequent monitoring prior to, and post manipulation, splintage or surgery. Neurovascular evaluation and documentation is important as a baseline for A thorough skin exam is therefore essential.Īs with all fractures near vital structures, careful initial The superficial position of the olecranon increases its In such cases the patient should be examined for other Obtaining a true lateral radiograph is essential to evaluate theĬomminution of an olecranon fracture is more likely in a high energy If the coronoid process is also fractured, the ![]() Of the proximal third of the ulna fracture combined with radial head With coronoid fractures, collateral ligament injuries, radial head and neckĬommonly associated with a Monteggia fracture. Olecranon fractures are commonly associated Individuals, a higher energy mechanism of injury is more common. Otherwise, olecranon fractures should therefore be considered to be fragilityįractures (prompting an investigation of metabolic bone disease). Years and older as a result of a fall from standing height. The majority of fractures occur in individuals 50 Its muscular action tends to displace the fracture, as shown. By contrast, a fall is associated with a displaced transverseįracture line, owing to the pull of the triceps (see Figure 2).įigure 2: Displaced olecranon fracture. Radius and ulna in relationship to the humerus.ĭirect blow usually results in a comminuted fracture (that is, one with manyįragments). Lateral view is a true lateral view and that the AP clearly shows the proximal Emphasis should be placed on ensuring the Radiographs in the anteroposterior (AP) and In cases of polytrauma, patients should beĬlosely evaluated for associated injuries. Palpable defect, though there is often a lack of (i.e., including the humerus, radius and nearby soft tissues).ĭisplaced olecranon fractures can create a Isolated injuries, though they also can be part of a more complex elbow injury Of high energy trauma in young individuals and a low energy fall in older Olecranon fractures are typically a result Of a fall, the triceps pull off a piece of the proximal ulna, a so-called avulsion fracture.) The mechanism of injury is either a directīlow to the elbow or a fall onto an outstretched upper extremity. Also, thereĪre risks of impaired post-operative wound healing and pressure damage from immobilizingįracture present with a history of trauma, elbow pain and have difficulty extending the elbow. Thin layer of soft tissue and skin overlying it. Thus, a “closed” olecranon fractureĬan easily become an “open” one (i.e., breaking through the skin). The olecranon is subcutaneous with only a.Must be protected when the injury is treated. Olecranon, so this nerve needs to be assessed when the olecranon is injured and Thus,Ī fractured olecranon is subject to displacement by the pull of the triceps. Third of the olecranon which provides a lever arm for extension of the elbow. The triceps tendon inserts on the posterior.Its anterior surface and the coronoid process articulate An olecranon fracture is an intra-articularįracture. ![]() There are key structure/function points to Figure 1: The bony landmarks of the proximal ulna TT-Triceps tendon, OP-Olecranon process, CP-Coronoid process.
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