An olecranon fracture is a break in the bony prominence (olecranon) at the proximal end of the ulna bone that forms the tip of the elbow. It is a common elbow fracture, accounting for around 10% of upper extremity fractures in adults.

Common Symptoms

• Sudden, intense pain in the elbow
• Inability to move or extend the elbow
• Swelling around the elbow
• Bruising around the elbow, possibly extending up/down the arm
• Tenderness when touched
• Numbness in one or more fingers
• Instability or feeling the elbow may “pop out”

Cause & Anatomy

The olecranon forms part of the elbow joint along with the humerus and radius bones. An olecranon fracture can occur from:

• Falling directly onto the elbow
• A direct blow to the elbow (e.g. from a bat, vehicle collision)
• Falling on an outstretched arm with the elbow locked, causing the triceps muscle attached to the olecranon to pull off a bone fragment

The olecranon is part of the articular surface of the elbow joint, so these fractures are intra-articular injuries.

Diagnosis

Diagnosis is made based on:

• History of the injury mechanism
• Physical examination findings like pain, swelling, bruising
• X-rays to visualize the fracture pattern

Prevention

Olecranon fractures typically result from trauma, so prevention involves using protective gear during activities with fall/impact risk.

Treatment

Treatment depends on the fracture pattern and degree of displacement:

• Nondisplaced fractures may be treated with immobilization alone but this is uncommon
• Displaced/unstable fractures usually require surgery to restore joint congruity and stability

Surgery

Surgical options include:

• Tension band wiring to stabilize the fracture fragments
• Plate and screw fixation, especially for comminuted fractures
• Excision of small fracture fragments with repair of the triceps tendon

Rehabilitation

After immobilization, physical therapy focuses on regaining range of motion and strength. Full recovery can take over a year, with some residual stiffness common.

FAQ’s

When can normal activities be resumed?
Most patients can return to normal activities around 4 months post-injury, though full healing may take over a year.

What are potential complications?
Potential complications include loss of motion, posttraumatic arthritis, symptomatic hardware requiring removal, nonunion, and elbow instability.