An olecranon fracture is an injury to the most prominent bone of the elbow. People may call the olecranon the 'funny bone.' The bone is actually the end of the ulna, one of the two forearm bones, and it is the attachment of the powerful triceps muscle of the arm. The triceps is the muscle that straightens the elbow, and olecranon fractures can impair a patient's ability to straighten the elbow joint.
How does an olecranon fracture occur?
Olecranon fractures can occur by either falling directly on the elbow, or by the triceps muscle pulling off a fragment of bone from the elbow. Stress fractures are also a possible mechanism of injury to the ulna, commonly seen in athletes such as baseball pitchers.
What is the treatment of an olecranon fracture?
Treatment of an olecranon fracture depends on the amount of displacement of the fracture fragments and the function of the triceps muscle. If the fracture is non-displaced, or minimally displaced, and the triceps muscle is able to extend the elbow, then surgery may not be necessary. In these cases, protected motion and time will generally heal the fracture. Otherwise, surgical treatment of olecranon fractures is the usual treatment.
When is surgery necessary for an olecranon fracture?
When the bone fragments are out of position, or if the triceps muscle is detached, then surgery is usually necessary for treatment of an olecranon fracture. There are several ways to fix an olecranon fracture. An incision is made over the back of the elbow joint, and the bone fragments are repositioned into the proper location. Some combination of pins, wires, and/or screws may be used to secure the bone fragments in the proper position.
What is the recovery from an olecranon fracture?
Patients are usually immobilized for a brief period, but the goal is to begin elbow motion as soon as possible. Usually gentle motion is started within the first week following surgery. The amount of motion allowed depends on the strength of the fracture repair and the surrounding bone. Total healing time of an olecranon fracture is about 12 weeks.
What are the complications from surgery for an olecranon fracture?
The most common complication following surgery for an olecranon fracture is that often the metal pins, wires, and/or screws must be removed. There is little soft-tissue "padding" over the back of the elbow, and these metal implants can be bothersome--especially when leaning on your elbow. In these cases, the hardware will be removed, usually about a year after surgery.
Patients also usually have slightly diminished motion of the injured elbow, although this usually is not noticed. If elbow motion is initiated soon after surgery, then most patients are able to recover most of their motion, only noticing a slight difference when comparing motion with their unaffected elbow. Other possible complications include:
- Infection
- Non healing fractures
- Failure of the fixation to hold the fragments in place
- Elbow pain
