Olecranon fracture: Difference between revisions
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Revision as of 10:43, 26 June 2016
Background
- Occurs via direct trauma or by fall w/ forced hyperextension of elbow
- Common in high energy mechanism in young and falls in elderly
- Associated injuries are common:
- Dislocations, radial head fx, ulnar nerve injury
Clinical Features
- Pain, swelling, and occasionally over posterior elbow
- Forearm extension strength is reduced (triceps inserts at the olecranon)
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Biceps tendon rupture/dislocation
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Pronator teres syndrome
- Septic bursitis
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
Imaging
- AP lateral, requires true lateral
- Radiocapitellar view helps visualize radial head fx, capitellar shear fx
- CT can assist with operative planning
Management
- Rule-out ulnar nerve injury
- Immobilize w/ long arm posterior mold w/ elbow in flexion and forearm neutral
- Refer to ortho w/in 24hr
- Elderly with limited mobility, consider non-op, splint at 45-90 degrees for 3-4 weeks
See Also
References
- Orthobullets