An olecranon fracture is a break of the upper end of your ulna.
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 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 of an olecranon fracture include:
• Pain and swelling
• Inability to move or straighten the elbow
• Numbness in your fingers, if your nerve is bruised.
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.
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.
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