Olecranon fracture

Revision as of 07:31, 17 May 2019 by Rossdonaldson1 (talk | contribs) (Evaluation)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)

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

Radiograph-Negative

Pediatric

Evaluation

Fracture of the olecranon (arrow).
Fracture of the olecranon on PA and lateral.
  • 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