Evolution of Technology

Olecranon Locking Plates

Olecranon fracture are commonly treated with locking plates and screws. Each implant regardless of the manufacturer allows for a combination of locking or non-locking screws to increase the stability of the fracture fixation. Locking screws allow the formation of a fixed angle construct the plate that creates a stiff fixed angle construct. An incision is commonly made on the posterior aspect of the elbow. At times, after surgery it may be necessary for the plate to removed due to irritation which would require hardware removal after the fracture has healed.

Evolution of Procedure

Olecranon Fracture Surgery

Olecranon fractures can be treated nonoperatively with a short-term immobilization and slowly advancing range motion at the elbow. When treated nonoperatively patients commonly have and extensor lag and are unable to fully extend (straighten the elbow) as they were prior to the injury.

The goal of surgical intervention is to restore the natural anatomy of the articular surface of the olecranon to allow and maintain optimal range of motion. Multiple options exist to treat these fractures such as tension band, intramedullary screw, plate and screw fixation, and fracture excision with triceps advancement. The tension band technique used to be fairly common however due to the advancement in implant technology, locking screws and plates have now become more popular and widely used. Multiple surgical techniques exist and can be combined depending on the fracture pattern.

Evolution of Diagnosis

Olecranon Fractures

Olecranon fractures are one of the more common injuries that occur in the upper extremity. The most likely mechanisms that leads to these fractures are from indirect trauma to the extremity or direct trauma to the elbow. The injury mechanism usually will align with the fracture type. Direct trauma is likely to result in a comminuted (multiple fragments) fracture, whereas indirect trauma likely results in a transverse or oblique fracture pattern.