Olecranon fracture: Difference between revisions
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*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 | ||
*Refer to ortho | *Refer to ortho within 24hr | ||
*Elderly with limited mobility, consider non-op, splint at 45-90 degrees for 3-4 weeks | *Elderly with limited mobility, consider non-op, splint at 45-90 degrees for 3-4 weeks | ||
==See Also== | ==See Also== | ||
Revision as of 01:38, 14 July 2016
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
- 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 fracture, capitellar shear fracture
- CT can assist with operative planning
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