Fractures of the Olecranon

Despite its strength, the olecranon is frequently fractured in adults because of its prominent positioning directly under the skin on the point of the elbow – where most direct injuries to the elbow occur.

Most olecranon fractures are sustained from a fall on the semi-flexed forearm. During the fall muscles tense to break the fall and the strong triceps muscle snaps the olecranon over the lower end of the humerus. Olecranon fractures can range from simple nondisplaced fractures to complex fracture dislocations of the elbow joint.

Among some of the symptoms of an olecranon fracture include: intense pain, bruising around the elbow, tenderness and swelling over the affected area, numbing in one or more fingers, and possible deformity.

These fractures are classified as, either a Type I, II, or III fracture. A Type I fracture is usually stable with little displacement or malalignment, Type II fractures are among the most common and represent generally stable fractures with displacement, and Type III fractures are displaced and impact over 50 percent of the joint surface – resulting in joint instability.

Treatment
Depending on the type of fracture, treatment may be either conservative or surgical. Generally only Type I fractures are treated nonsurgically with a splint or sling – holding the elbow at a 90 degree angle. There is careful monitoring to ensure that the bones do not become displaced during the healing process.

Type II and Type III fractures are generally treated surgically with internal fixation. All surgery is followed by patient appropriate physical therapy and range of motion exercises.