Olecranon fractures typically occur in conjunction with other elbowinjuries, notably a radial neck fracture or dislocation of the radial head Monteggia variant, or lateral condyle fractu
Trang 1Olecranon fractures typically occur in conjunction with other elbow
injuries, notably a radial neck fracture or dislocation of the radial head (Monteggia variant), or lateral condyle fracture
Comparative views may be helpful in distinguishing the olecranon
growth plate from a fracture
A missed fracture of the olecranon epiphysis can lead to a fixed flexion deformity resulting in significant morbidity in adulthood
The mechanism of an isolated olecranon fracture is hypothesized to be a sudden flexion of the elbow when the triceps is strongly contracted (essentially an avulsion injury), direct trauma, or stress fracture from repeated throwing activity Physical findings range from localized swelling to a marked hemarthrosis with weak or absent elbow extension Nondisplaced fractures may be somewhat difficult to discern on the standard anteroposterior and lateral radiographs; however, the presence of an abnormal fat pad should be viewed as presumptive
evidence of a bony injury ( Fig 111.22 ) Olecranon fractures of <3 mm can be
stably splinted in partial extension and referred for outpatient orthopedic
follow-up Displaced fractures and stress fractures often require open reduction and internal fixation Immediate orthopedic consultation is indicated for displaced fractures, open fractures, multiple fractures, and neurovascular injury Isolated olecranon fractures almost invariably heal quickly and without significant complications
Radial Head and Neck Fractures
CLINICAL PEARLS AND PITFALLS