Georgios Panagopoulos MD | Orthopaedic Surgeon
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What is an olecranon fracture?
The elbow joint consists of 3 bones: the humerus (arm bone), ulna and radius (forearm bones). These bones are held together by multiple muscles, tendons and ligaments and work in unison in a hinge joint that bends your elbow, but also controls rotation of your forearm and hand. The upper pointy edge of the ulna near the elbow is called olecranon. An olecranon fracture is a break of the upper end of your ulna.
Causes
An olecranon fracture may occur as a result of a direct blow at the elbow (fall on the elbow, hit by an object) or indirectly after a fall on the outstretched hand.
Symptoms
Symptoms of an olecranon fracture include:
- Immediate pain
- Severe bruising and swelling of the elbow
- Inability to straighten or bend the arm
Diagnosis
The doctor will take a complete history and examine you thoroughly, taking care not to cause any further pain or discomfort. A simple x-ray of the elbow is usually enough for an accurate diagnosis. Your surgeon may request further imaging for preoperative planning, such as a CT scan, if deemed necessary.
Treatment
In general, olecranon fractures are displaced and require surgery. Surgery involves an incision at the back of your elbow. That way your surgeon can get to the fracture site and put all the pieces back together.
There are different means of fixation, i.e., pins with wires (tension band wiring), plate & screws (ORIF), or suture fixation. After surgery, a simple dressing is put in place, and you will be encouraged to start gentle mobilization to avoid elbow stiffness.
Your doctor and physiotherapist will create a customized rehabilitation plan for you. As the olecranon is right underneath the skin, it is not uncommon for patients to complain that their metalwork is prominent or bothersome. In that case, patients can be scheduled for metalwork removal 6-9 months after the initial operation. Conservative management is reserved for patients with minimally displaced fractures, as well as low demand or high-risk patients.
Sometimes, olecranon fractures are associated with more complex elbow injuries, like a radial head fracture, transolecranon fracture - dislocation, etc. In these cases, a more complex surgery is typically needed, in order to repair all structures involved.
Dr Panagopoulos has extensive experience in the treatment of elbow fractures, and will discuss with you all options during your visit in our office.
FAQs - Frequently Asked Questions
What's the olecranon?
The upper pointy edge of the ulna near the elbow is called olecranon.
What causes an olecranon fracture?
An olecranon fracture may occur as a result of a direct blow at the elbow (fall on the elbow, hit by an object) or indirectly after a fall on the outstretched hand.
What's the treatment?
In general, olecranon fractures are displaced and require surgery. Surgery involves an incision at the back of your elbow. That way your surgeon can get to the fracture site and put all the pieces back together.
Do I have to remove the metalwork at a later time?
Metalwork does not have to be removed, unless symptomatic.
Can surgery be done without plates or wires?
Selected fractures may be treated with suture-fixation.
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