Executive Editor: Peter Trafton, Michael Baumgaertner

Authors: Peter Kloen, David Ring

Proximal forearm Ulna, articular, olecranon

back to skeleton

Glossary

Transverse olecranon fractures with no fragmentation can be treated with tension band wiring or a plate. Infirm, dependent patients can do well with nonoperative treatment.

Nonoperative
Indication summary Skill Equipment
Undisplaced fractures Basic surgical experience, no specialized skills Basic equipment only

Further indications

  • Displaced fractures in infirm, dependent individuals (eg demented persons dependent on others for basic tasks such as bathing and eating)
  • Infirm or dependent person

Contraindications

  • Polytrauma

Advantages

  • Avoid medical and surgical risks

Disadvantages

  • Risk of displacement which is difficult to reconstruct later if unsatisfied with elbow extension strength
Temporary external fixation
Indication summary Skill Equipment
Extensive soft-tissue damage Some specialized surgical experience Simple surgical and imaging resources

Further indications

  • Infection or severe contamination
  • Major bone loss
  • Joint instability

Advantages

  • Quick procedure
  • Easy to perform
  • No additional damage to already injured tissue
  • Stabilizes the fracture for soft-tissue healing

Disadvantages

  • Temporary procedure
  • Pin-track complications
  • Iatrogenic nerve injury
Tension band wiring
Indication summary Skill Equipment
Transverse simple fracture of the olecranon Some specialized surgical experience Basic equipment only

Contraindications

  • Fragmentation of the articular surface
  • Fracture dislocation

Advantages

  • Inexpensive implant

Disadvantages

  • Risk of joint penetration with K-wires
  • Risk of backing-out of K-wires and implant prominence
  • Risk of fragmentation in osteoporotic bone
  • Fatigue failure of the tension band
Bridge plate
Indication summary Skill Equipment
Multifragmentary fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Contraindications

  • Infirm and dependent patients
  • Severe skin problems or infection

Advantages

  • Restoration of anatomy and function

Disadvantages

  • Medical and surgical risks
Lag screw with neutralization plate
Indication summary Skill Equipment
Oblique simple fracture of the olecranon Some specialized surgical experience Simple surgical and imaging resources

Contraindications

  • Multifragmentary fracture
  • Simple transverse fracture

Advantages

  • Anatomical reduction
  • Stable fixation
  • Functional motion

Disadvantages

  • Symptomatic prominent hardware
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v2.0 2018-04-30