Less commonly, in younger patients, these are high energy injuries resulting from direct trauma and may be associated with other forearm injuries or fractures. The triceps muscle will also act to further distract the fracture this is important to appreciate as it influences the management of these injuries. Fractures of the olecranon typically result from indirect trauma when a patient falls on an outstretched arm, resulting in the sudden pull of the triceps (and brachialis) muscle. The olecranon is the site of insertion for the triceps muscles. It articulates with the trochlea of the distal humerus, and all olecranon fractures are therefore intra-articular fractures by definition The olecranon is the region of the proximal ulna from its tip to the coronoid process. In this article, we will look at the pathophysiology, clinical features, investigations and management of olecranon process fractures. They occur with a bimodal age distribution occurring in the young following high energy injuries and in the elderly (more common) following low energy indirect injuries. Olecranon process fractures are relatively common fractures of the upper limb. There is a very high rate of removal of metalwork, as due to the very superficial nature of the injury, it often impacts the patient significantly.Non-operative management is usually indicated for displacement 2mm, requiring (depending on fracture configuration) techniques such as tension band wiring (if fracture proximal to the coranoid process) or olecranon plating (if at level of, or distal to, the coranoid process) may be used.Management will often vary between centre, surgical preference, and patient factors, however as an overview: Any complex injuries such as fracture dislocations or neurovascular compromise should warrant urgent senior discussion. Treatment is usually guided by the degree of displacement on imaging. Early motion begins immediately following surgery and usually is assisted by occupational therapy or physical therapy.Ensure the patient is resuscitated appropriately and stabilised, prior to definitive management of the fracture. The pieces are then put together and held in place in different ways: pins/wires, screws only or plates and screws. Surgery is often performed through an incision over the back of the elbow that allows full access to the fractures. If the fracture is displaced or the fracture is open (bone is exposed through the skin), surgery is usually necessary. For this reason, nonsurgical treatment is rarely recommended. Because of the prolonged splinting time, the elbow may become very stiff and require a longer period of therapy after the cast is removed to regain motion. Weight lifting and bearing will not be allowed for several weeks. If the fracture is not displaced (out of place), you may be allowed to start gently moving the elbow with the assistance of a physical therapist after a few weeks. The doctor will closely monitor the healing of the fracture and have you frequently return to clinic for X-rays. Nonsurgical TreatmentĪ splint or sling is used to hold the elbow in place during the healing process. There are usually two treatments for elbow fractures depending on the fracture pattern, displacement and joint involvement. What is the treatment for olecranon fracture? Sudden intense pain with inability to straighten the elbow What are the symptoms of an elbow fracture? The latter is mostly secondary to landing on an outstretched arm. This type of fracture is common and usually occurs in isolation (there are no other injuries) but can also be a part of a more complex elbow injury.Īn olecranon fracture can occur through a direct blow (i.e., fall on the elbow or direct impact from an object) or indirect blow. It bends and straightens like a hinge, but it is also important for rotation of the forearm that is, the ability to turn our hands up (like accepting change from a cashier) or down (like typing or playing piano).Īn olecranon fracture is a break in the “pointy bone” of your elbow that sticks out when you bend your arm, which is actually the end of the ulna. The elbow joint is made up of three bones, the humerus (upper arm bone), ulna (first of two forearm bones on pinky side) and radius (second of two forearm bones on thumb side) and is held together by ligaments, muscle and tendons.
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