Olecranon fractures: treatment options

Olecranon fractures are a common injury in the adult population. They are caused by different mechanisms of injury determining different type of injuries ranging from simple fracture to transolecranon fracture-dislocation and then complex fracture-dislocation of the elbow joint. Since olecranon fractures involve the articular surface, the key element in the treatment of this fracture, no matter how complex, is to restore the contour and dimensions of the trochlear notch of the ulna that represent the key to restoring elbow stability. Different methods of surgical treatments has been described in the literature, and include screw fixation, cerclage wiring, simple or modified tension-band wiring with metal or polyester and polyethylene sutures, plate fixation, and fragment excision with triceps advancement. No single treatment method is appropriate for all fractures. Different clinical factors, fracture type and biomechanical studies guide the surgeon in determining a treatment plan. However, the aim of the treatment is to obtain a fixation construct stable enough to permit immediate mobilization, thereby diminishing the risk of stiffness and heterotopic ossification.