Olecranon fracture: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Pain, swelling, and occasionally over posterior elbow | *Pain, swelling, and occasionally over posterior elbow | ||
*Assess extensor mechanism by assessing elbow extension against resistance | |||
*Forearm extension strength is reduced (triceps inserts at the olecranon) | *Forearm extension strength is reduced (triceps inserts at the olecranon) | ||
| Line 12: | Line 13: | ||
{{Elbow DDX}} | {{Elbow DDX}} | ||
== | ==Evaluation== | ||
[[File:OlecranonFracMark.png|thumb|Fracture of the olecranon (arrow).]] | |||
[[File:PMC4231343 1471-2474-14-308-2.png|thumb|Fracture of the olecranon on PA and lateral.]] | |||
*AP lateral, requires true lateral | *AP lateral, requires true lateral | ||
*Radiocapitellar view helps visualize radial head fracture, capitellar shear fracture | *Radiocapitellar view helps visualize radial head fracture, capitellar shear fracture | ||
*CT can assist with operative planning | *CT can assist with operative planning | ||
==Management== | ==Management== | ||
*Rule-out ulnar nerve injury | *Rule-out ulnar nerve injury | ||
*Immobilize with long arm posterior mold with elbow in flexion and forearm neutral | *Immobilize with long arm posterior mold with elbow in flexion and forearm neutral | ||
*Refer to ortho | *Refer to ortho within 24hr | ||
*Elderly with limited mobility, consider non-op, splint at 45-90 degrees for 3-4 weeks | *Elderly with limited mobility, consider non-op, splint at 45-90 degrees for 3-4 weeks | ||
==See Also== | ==See Also== | ||
Revision as of 07:31, 17 May 2019
Background
- Occurs via direct trauma or by fall with forced hyperextension of elbow
- Common in high energy mechanism in young and falls in elderly
- Associated injuries are common:
- Dislocations, radial head fracture, ulnar nerve injury
Clinical Features
- Pain, swelling, and occasionally over posterior elbow
- Assess extensor mechanism by assessing elbow extension against resistance
- Forearm extension strength is reduced (triceps inserts at the olecranon)
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Biceps tendon rupture/dislocation
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Pronator teres syndrome
- Septic bursitis
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
Evaluation
- AP lateral, requires true lateral
- Radiocapitellar view helps visualize radial head fracture, capitellar shear fracture
- CT can assist with operative planning
Management
- Rule-out ulnar nerve injury
- Immobilize with long arm posterior mold with elbow in flexion and forearm neutral
- Refer to ortho within 24hr
- Elderly with limited mobility, consider non-op, splint at 45-90 degrees for 3-4 weeks
See Also
References
- Orthobullets