Olecranon Fracture
What is an Olecranon fracture?
An olecranon fracture is a break in the olecranon, the bony prominence at the back of the elbow. This is the tip of the ulna (one of the two forearm bones) and forms the pointy part you feel when you bend your elbow. This fracture directly affects elbow extension and stability.
What are the causes of an Olecranon fracture?
Common mechanisms include a direct trauma, such as a fall on an outstretched hand with the elbow flexed. This fracture can also be caused by a sudden increase in weight bearing (trying to break a fall) or a high-energy trauma (sports injuries, motor vehicle accidents).
Some of the risk factors of an olecranon fracture include diagnosis of osteoporosis, elderly patients (falls), episodes of Seizures, or involvement of contact sport.
What are some of the symptoms of an Olecranon fracture?
- Immediate posterior elbow pain
- Swelling and bruising
- Inability or difficulty extending the elbow against gravity
- Visible deformity (if displaced)
- Tenderness over the olecranon
- Possible numbness/tingling in the ring and little finger (nerve involvement)
How is a Olecranon fracture diagnosed?
An Olecranon fracture can be diagnosed by a physician through a physical examination. In addition, X-rays (AP and lateral elbow views) or a CT scan for complex or comminuted fractures. In addition to diagnosing an Olecranon fracture, the physician can also classify the injury based on presentation. The types of Olecranon fractures include nondisplaced vs displaced, comminuted (multiple fragments), and open fractures.
What are some of the treatment options for an Olecranon fracture?
Treatment depends on displacement, stability, and patient factors. Conservative management would be indicated if there is a nondisplaced or minimally displaced fracture, or there is an intact extensor mechanism. Conservative management includes splinting, immobilization (~2-3 weeks) and early motion once stable. Surgical intervention would be indicated if there is a displaced fracture, loss of elbow extension, open fractures, and any elbow instability. The physician will elect a surgical procedure based on presentation and patient factors.
Rehabilitation for an Olecranon fracture
Rehabilitation of an Olecranon fracture focuses on fracture healing in combination with early motion to prevent stiffness or loss of motion. Rehabilitation should be closely monitored by a hand therapist to ensure correct and safe progression.
During the early phases of rehabilitation (~0-2 weeks), the goals include immobilization, decreasing pain and inflammation, and ensuring continued range of motion (ROM) of the hand, wrist, and shoulder. The Certified Hand Therapist (CHT) may fit you with a hinged elbow brace or custom orthotic. During the second phase (~2–6 weeks), the hand therapist will guide you through gradual active elbow ROM, and light isometric exercises (as permitted). The final phase of rehabilitation (~6-12 weeks) focuses on progressive strengthening and slow return to functional activities. Full return to activities may take up to ~3-4 months.
The rehabilitation process and timeline will vary based on multiple factors such as instability, delayed healing, or other guidelines from the surgeon. It is important that you see a therapist that specializes in Orthopedic care of the Upper Extremity such as a Certified Hand Therapist (CHT), to ensure proper progression through the rehab process to avoid re-injury.
