Isolated olecranon fractures are usually due to a fall on an outstretched hand or a direct blow to the elbow. Avulsion fractures of the olecranon rarely occur when the triceps tendon pulls off a piece of the olecranon.
Symptoms and Signs of Isolated Olecranon Fractures
Patients present with pain, swelling, and tenderness of the olecranon; there may also be a deformity. Extension of the elbow is limited or impossible.
Diagnosis of Isolated Olecranon Fractures
Neurovascular examination
Imaging tests
Distal neurovascular examination is vital, because the ulnar nerve can be injured. Standard anteroposterior and lateral views of the elbow reveal most fractures, most obviously on the lateral view.
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Treatment of Isolated Olecranon Fractures
Surgery
Long arm posterior splint
Antibiotics and orthopedic consultation (for open fractures)
Greater severity of displacement and/or comminution usually require operative management. The Mayo classification is commonly used to classify the degree of displacement, comminution, and stability (1). Initial management for most cases is a long arm posterior splint and close orthopedic follow-up. Open fractures should be managed with immediate antibiotics and orthopedic consultation.
Treatment reference
1. Sullivan CW, Desai K: Classifications in brief: Mayo classification of olecranon fractures. Clin Orthop Relat Res 477(4):908–910, 2019. doi: 10.1097/CORR.0000000000000614
