Olecranon fracture: Difference between revisions

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{{Adult top}} [[olecranon fracture (peds)]]
==Background==
==Background==
*Occurs via direct trauma or by fall with forced hyperextension of elbow
*Occurs via direct trauma or by fall with forced hyperextension of elbow
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{{Elbow DDX}}
{{Elbow DDX}}


==Imaging==
==Evaluation==
[[File:OlecranonFracMark.png|thumb|Fracture of the olecranon (arrow).]]
[[File:PMC4231343 1471-2474-14-308-2.png|thumb|Fracture of the olecranon on PA and lateral.]]
*AP lateral, requires true lateral
*AP lateral, requires true lateral
*Radiocapitellar view helps visualize radial head fracture, capitellar shear fracture
*Radiocapitellar view helps visualize radial head fracture, capitellar shear fracture
*CT can assist with operative planning
*CT can assist with operative planning
==Management==
==Management==
{{General Fracture Management}}
===Specific Management===
*Rule-out ulnar nerve injury
*Rule-out ulnar nerve injury
*Immobilize with long arm posterior mold with elbow in flexion and forearm neutral
*Immobilize with long arm posterior mold with elbow in flexion and forearm neutral

Latest revision as of 23:39, 28 November 2019

This page is for adult patients. For pediatric patients, see: olecranon fracture (peds)

Background

  • Occurs via direct trauma or by fall with forced hyperextension of elbow
  • Common in high energy mechanism in young and falls in elderly
  • Associated injuries are common:
    • Dislocations, radial head fracture, ulnar nerve injury

Clinical Features

  • Pain, swelling, and occasionally over posterior elbow
  • Assess extensor mechanism by assessing elbow extension against resistance
  • Forearm extension strength is reduced (triceps inserts at the olecranon)

Differential Diagnosis

Elbow Diagnoses

Radiograph-Positive

Radiograph-Negative

Pediatric

Evaluation

Fracture of the olecranon (arrow).
Fracture of the olecranon on PA and lateral.
  • AP lateral, requires true lateral
  • Radiocapitellar view helps visualize radial head fracture, capitellar shear fracture
  • CT can assist with operative planning

Management

General Fracture Management

Specific Management

  • Rule-out ulnar nerve injury
  • Immobilize with long arm posterior mold with elbow in flexion and forearm neutral
  • Refer to ortho within 24hr
  • Elderly with limited mobility, consider non-op, splint at 45-90 degrees for 3-4 weeks

See Also

References


  • Orthobullets