Elbow - Olecranon Fracture
Description
An olecranon fracture is a break in the forearm bone on the outer aspect of the wrist (pinky side). The olecranon meets the end of the humerus, forming the hinge joint of the elbow. Flexion and extension of the elbow occurs at this joint.
What are the causes?
Patients that are older or those with weakened bone (osteoporosis, osteopenia, tumors, etc.) are susceptible to fracture after trauma. A direct fall on the tip of the elbow is most common mechanism of olecranon fracture.
What are the symptoms?
Olecranon fractures cause pain and loss of function, including the ability to fully extend or flex the elbow and rotate the wrist. Patients will often experience clicking when they try to bend and extend the elbow.
How is it diagnosed?
Dr. Liu will perform a physical exam and obtain X-rays. Your surgeon may order additional diagnostic tests to evaluate the fracture better (CT/”CAT” scan) to better evaluate the bone or MRI to evaluate the muscles, tendons and ligaments.
Non-operative
Non-operative treatment is recommended for non-displaced fractures and those that do not extend into the joint. Your surgeon may recommend medication, a sling, cryotherapy and activity modification while the fracture heals. Scheduled visits with your surgeon for repeat X-rays is common. Physical therapy is at your surgeon’s discretion.
Operative
Operative treatment is recommended when the fracture is not in line (aka - displaced) and the chance of healing in a normal position is minimal. Your surgeon has multiple choices of fixation techniques and depends on the fracture type, risk of not healing and patient activity level. The fracture can be fixed with sutures and anchors, pins, a plate and screws or an elbow replacement. Postoperative medication and physical therapy are at your surgeon’s discretion.
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Complications of Olecranon Fractures
Even with successful treatment, some patients with olecranon fractures may experience long-term complications.
Loss of Motion
In some cases, a patient may not be able to regain full motion in the affected elbow. In most of these cases, the patient cannot fully extend or straighten his or her arm. Fortunately, the loss of a few degrees of straightening does not usually affect the overall function of the arm. Patients who have significant loss of motion may require intensive physical therapy, special bracing, or further surgery. This is uncommon for olecranon fractures.
Posttraumatic Arthritis
Posttraumatic arthritis is a type of arthritis that develops in a joint after an injury. Even when your bones heal normally, the cartilage lining the joint surfaces can be damaged, leading to pain and stiffness over time.
Posttraumatic arthritis is a relatively common complication of olecranon fractures. It can occur shortly after the fracture occurs or can take years to develop. Some patients with posttraumatic arthritis may need further surgery to relieve their symptoms. However, for many patients, there is little pain and no need for further treatment.
Outcomes
Most patients can return to their normal activities within about 4 months, although full healing can take more than a year. Recovering strength in your arm often takes longer than might be expected.
Although x-rays may show that the fracture has healed completely, some patients report that they still have limitations in movement. These patients will usually continue to improve over time.
Questions to Ask Your Doctor
If you experience an olecranon fracture, here are some questions you may wish to ask your doctor:
- When can I start moving my elbow?
- How soon can I resume my normal activities?
- What factors will prolong or delay healing?
- If I have to have surgery, what are the benefits and risks?
- What will my recovery be like?