We need you! See something you could improve? Make an edit and help improve WikSM for everyone.

Pediatric Olecranon Fracture

From WikiSM
Jump to: navigation, search

Other Names

  • Elbow Fracture


  • Refers to fracture of the Olecranon of the proximal Ulna in children


  • Uncommon fracture pattern in children
  • Represent approximately 5% of elbow fractures in children[1]
  • Occurs most commonly between ages 5-10[2]
  • 65% male


  • Mechanism typically involves fall on outstreched arm
    • Flexed elbow with contracting Triceps Brachii, Brachialis may lead to avulsion fracture (less common in children)
    • Extended elbow
    • Direct trauma
  • Stress fracture can occur from overuse injury and be subacute
  • Types
    • Short, oblique
    • Transverse


  • Location
    • Metaphyseal (most common)
    • Physeal
    • Epiphyseal
      • Intra-articular
      • Extra-articular

Ossification Centers of the Elbow

Ossification center Age of Appearance on Xray Age of fusion
Capitellum 1 12
Radial Head 3 15
Medial Epicondyle 5 17
Trochlea 7 12
Olecranon 9 15
Lateral Epicondyle 11 12

Associated Injuries

Risk Factors

Differential Diagnosis

Clinical Features

  • General: Physical Exam Elbow
  • History
    • Patient will endorse trauma
    • Reports pain, swelling, bruising, inability to flex or extend elbow
  • Physical
    • Inspect for swelling, bruising
    • Loss of range of motion


Lateral view showing olecranon fracture with migration of proximal fragment


  • Standard Radiographs Elbow
    • Standard elbow radiographs usually sufficient
    • May see lucency usually reaching the trochlear groove articular surface


  • N/A



  • Indications
    • Stress fracture or reactions
    • Apophysitis
    • Minimally displaced fractures, typically <2 mm
  • Immobilization in Long Arm Cast for acute injuries
  • Relative rest
  • Avoidance of provocative activities
  • Physical Therapy


  • Indications
    • Displaced fractures >2 mm
    • unstable or comminuted

Return to Play

  • Variable
  • For overuse injuries, graduated return to play


See Also


  1. Landin LA, Danielsson LG. Elbow fractures in children. An epidemiological analysis of 589 cases. Acta Orthop Scand. 1986;57(4):309–12.
  2. Erickson M, Frick S. Fractures involving the proximal radius and ulna. In: Rockwood CA, Wilkins KE, King RE, editors. Rockwood and Wilkins fractures in children. 7th ed. Philadelphia: J.B. Lippincott. p. 427–42. Section 2 Ch. 11.
  3. Evans MC, Graham KH. Olecranon fractures in children: part 1: a clinical review, part 2: a new classification and management algorithm. J Pediatr Orthop. 1999;19(5):559–69.
Created by:
John Kiel on 18 June 2019 01:16:43
Last edited:
13 October 2022 13:26:37