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Olecranon Fracture

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(Redirected from Olecranon Fractures)


Other Names

  • Triceps Avulsion Fracture
  • Elbow Fracture

Background

Epidemiology

  • Represent ~10% of elbow fractures (need citation)
  • Bimodal (need citation)
    • Young males with high energy mechanism
    • Adult females with low energy mechanism

Pathophysiology

Etiology

  • Universally traumatic
    • Direct blow involving fall directly onto posterior elbow
    • Fall in out stretched upper extremity
    • Less commonly, eccentric contraction of Triceps Brachii on partially flexed elbow

Risk Factors

  • Unknown

Differential Diagnosis

Clinical Features

  • General: Physical Exam Elbow
  • History
    • Description of trauma
    • Posterior elbow pain
  • Physical Exam
    • Palpable tenderness, defect
    • Inability to extend elbow, may indicate loss of extensor mechanism

Evaluation

Comminuted fracture of the olecranon extending into the joint space. This patient was admitted to the hospital for surgical management
  • Radiographs
    • Standard 3 view elbow typically sufficient
    • Lateral best view to evaluate fracture pattern
    • Consider radiocapitellar view
  • CT
    • Helpful for more clearly evaluating joint especially if complex or comminuted
    • Useful in preoperative planning

Classification

Mayo Classification

  • Type I: Undisplaced[1]
  • Type II: Displaced
    • A: Noncomminuted
    • B: Comminuted
  • Type III: Unstable
    • A: Noncomminuted
    • B: Comminuted

Colton Classification

  • Nondisplaced: Displacement does not increase with elbow flexion
  • Avulsion (displaced)
  • Oblique and Transverse (displaced)
  • Comminuted (displaced)
  • Fracture dislocation

Schatzker Classification

  • Type A: Simple transverse fracture
  • Type B: Transverse impacted fracture
  • Type C: Oblique fracture
  • Type D: Comminuted fracture
  • Type E: More distal fracture, extra-articular
  • Type F: Fracture-dislocation

AO Classification

  • Type A: Extra-articular
  • Type B: Intra-articular
  • Type C: Intra-articular fractures of both the radial head and olecranon

Management

Nonoperative

  • Indications
    • Nondisplaced
    • Minimally displaced in elderly, low demand patients
  • Immobilization
    • Acute: Posterior Long Arm Splint with elbow flexed to 90°
    • Subacute: Prefab removable splint to help minimize loss of ROM
    • Begin rehabilitation early to minimize capsulitis or loss of range of motion
    • Active motion against resistance typically doesnt occur until 8-10 weeks with callous formation[2]

Operative

  • Indications
    • Displaced fracture
    • Transverse fracture
    • Comminuted
    • Monteggia
    • Fracture-dislocation
    • Oblique fractures
  • Technique
    • Tension band
    • IM Fixation
    • Plate and screw

Return to Play

  • Highly variable
  • Surgeon discretion

Complications

See Also

References

  1. ↑ https://www.orthobullets.com/trauma/1022/olecranon-fractures
  2. ↑ Veillette, C. J. H., & Steinmann, S. P. (2008). Olecranon Fractures. Orthopedic Clinics of North America, 39(2), 229–236. doi:10.1016/j.ocl.2008.01.002
Created by:
John Kiel on 18 June 2019 01:12:29
Authors:
Last edited:
26 May 2026 12:18:50
Categories:
Trauma | Elbow | Upper Extremity | Fractures | Acute
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