Olecranon #

Question 1

Who does this affect?

Answer 1

• Bimodal distribution
• Young - high energy
• Older - low energy indirect injury

Question 2

Pathophys of olecranon #

Answer 2

• Olecranon (proximal ulna) articulates with trochlea of humerus
• all olecranon #’s are INTRA-ARTICULAR
• Site of insertion of triceps - FOOSA = sudden pull on triceps

Question 3

Parts of elbow joint

Answer 3

Question 4

Clinical presentation olecranon #

Answer 4

• History of FOOSH
• Elbow pain and swelling
• Lack of mobility of elbow
• Tendernss over posterior elbow - sometimes palpable defect

Question 5

Examination findings olecranon #

Answer 5

• Disruputed triceps mechanism
• = inability to extend elbow against gravity
• Other injuries can be found eg wrist ligament and bone injuries, radial head #

Question 6

Investigations for olecranon #

Answer 6

• Plain AP and lateral X-rays
• Affected joint and joints above and below
• Can often see displaced portion due to triceps pulling it
• CT if complex

Question 7

Classfication system of olecranon #

Answer 7

• Mayo
• Schatzker

Question 8

Management of olecranon #

Answer 8

• Adequate analgesia
• Depends on degree of displacement

Question 9

Non-operative management of olecranon #

Answer 9

• Displacement <2mm
• Immobilise in 60-90 degree elbow flexion and early introduction to ROM at 1-2 weeks
• If over 75, increasing use of non-op management irrespective of displacement

Question 10

Operative management olecranon #

Answer 10

• Displaced >2mm
• Tension band wiring (if proximal to coranoid process)
• Olecranon plating if at level of or distal to coranoid process
• High rate of removal of metalwork, superficial injury so impacts patient significantly