Fratura do Olecrano

Patients › Elbow

Olecranon fractures — patterns, non-operative care, and tension-band or plate fixation.

Updated Jun 2026

Uma ilustração desenhada à mão de uma pessoa sem rosto caindo e aterrissando diretamente sobre a ponta do cotovelo dobrado. — Raio X mostrando uma fratura do olécranon — a ponta óssea do cotovelo. Kieran Hirpara 4.0

O que você está sentindo

Você sentirá uma dor aguda na parte de trás do cotovelo. Este é o local onde o osso pontiagudo do seu braço se encontra com o antebraço. A dor frequentemente se intensifica quando você tenta estender o braço contra resistência. Você pode notar inchaço e equimose ao redor da articulação. Pode ser difícil levantar qualquer coisa mais pesada do que uma xícara de café. Tarefas simples, como alcançar as costas para fechar um sutiã ou guardar a camisa dentro da calça, tornam-se muito desafiadoras.

Seu cotovelo pode parecer rígido, especialmente quando você acorda pela manhã. Mover a articulação em toda a sua amplitude de movimento pode ser doloroso. Você pode ter dificuldade para dormir do lado da lesão. A dor também pode piorar após o uso do braço nas atividades diárias. Descansar com o braço apoiado geralmente traz algum alívio. No entanto, manter o braço completamente imóvel por muito tempo pode piorar a rigidez.

Como a fratura envolve a superfície articular, você pode sentir uma sensação de atrito ou ouvir sons de estalo ao se mover. Isso ocorre devido aos ossos esfregando uns contra os outros onde deveriam deslizar suavemente. Em adultos mais velhos, essa artrise por desgaste afeta cerca de 19% dos pacientes dentro de alguns anos. Você pode experimentar dores ocasionais que persistem muito tempo após a cura da lesão inicial. Esses sintomas podem aparecer e desaparecer, frequentemente desencadeados por mudanças climáticas ou uso intenso.

Se você tiver mais de 70 anos, seu cirurgião pode discutir opções não cirúrgicas. Essas abordagens focam no controle da dor e na manutenção da função, em vez de um alinhamento ósseo perfeito. Muitos pacientes relatam alta satisfação com esse método, mesmo que o osso não cicatrize em uma posição perfeita. O objetivo é ajudá-lo a realizar tarefas diárias com o mínimo de desconforto. Seu cirurgião adaptará o plano às suas necessidades específicas e nível de atividade.

O que está realmente acontecendo

O olécrano é a ponta óssea do cotovelo na qual você apoia o braço sobre uma mesa. Ele faz parte do úmero, um dos dois ossos do antebraço. Quando esse osso se fratura, frequentemente há lesão do tendão do tríceps, que atua como uma corda forte presa ao osso. Essa conexão permite que você estique o braço contra a gravidade. Se a fratura estiver deslocada, essa “corda” pode se descolar do fragmento ósseo, dificultando ou impossibilitando levantar a mão ou sustentar objetos.

O principal objetivo do seu cirurgião é restaurar a superfície lisa onde o osso do braço se encontra com o osso do antebraço. Essa superfície articular deve ser uniforme para que os ossos deslizem uns sobre os outros sem atrito. Se a fratura não for fixada de forma segura, o cotovelo pode tornar-se rígido. A mobilização precoce é fundamental para prevenir essa rigidez. O cirurgião escolherá um método de fixação que mantenha o osso estável o suficiente para permitir que você movimente o braço logo após a cirurgia, ao mesmo tempo em que protege o osso em processo de cicatrização.

Às vezes, a fratura é muito complexa ou a qualidade óssea é insuficiente para uma reparação padrão. Nesses casos, o cirurgião pode remover completamente o fragmento fraturado e reatar o tendão do tríceps diretamente ao osso do antebraço. Essa abordagem evita as complicações associadas a implantes e frequentemente resulta em melhor função com menos dor. Para pacientes mais idosos com demandas de atividade física mais baixas, o tratamento não cirúrgico também pode ser uma opção segura e eficaz.

Mesmo com o tratamento bem-sucedido, a osteoartrite por desgaste pode se desenvolver na articulação do cotovelo ao longo do tempo. Dados mostram que 19% dos pacientes desenvolvem essa condição, com um tempo mediano de acompanhamento de 41 meses. Isso significa que, para alguns, o revestimento cartilaginoso liso que recobre as extremidades ósseas se desgasta, potencialmente causando dor ou rigidez mais tarde na vida. No entanto, a maioria dos pacientes alcança boa função e satisfação a longo prazo, independentemente de terem sido submetidos à cirurgia ou a manejo conservador.

O que podemos fazer a respeito

Para muitos pacientes, especialmente adultos mais velhos ou aqueles com demandas físicas menores, o tratamento não operatório é uma escolha segura e eficaz. Seu cirurgião pode recomendar repouso, gelo e uma tala para manter o cotovelo imóvel enquanto o osso cicatriza. Essa abordagem foca no conforto e permite a cicatrização natural sem cirurgia. Estudos demonstram que fraturas isoladas e deslocadas em idosos frequentemente resultam em resultados satisfatórios a curto e longo prazo com esse método. Você pode esperar manter um arco de movimento funcional e experimentar dor mínima. Mesmo que o osso não se una completamente (não união), muitos pacientes ainda alcançam função razoável do cotovelo e raramente solicitam cirurgia posteriormente. Para pacientes mais jovens ou aqueles com deslocamento significativo, a cirurgia é frequentemente o padrão para restaurar a estabilidade.

O controle da dor é uma parte fundamental da sua recuperação. Seu cirurgião pode prescrever analgésicos ou medicamentos anti-inflamatórios para ajudá-lo a permanecer confortável durante o processo de cicatrização. Embora injeções como cortisona, ácido hialurônico ou PRP sejam comuns para dor articular, as evidências para fraturas do olécrano concentram-se principalmente na cicatrização estrutural, em vez dessas injeções específicas. O objetivo é controlar a dor para que você possa iniciar movimentos suaves assim que for seguro. O movimento precoce é crítico para evitar que a articulação do cotovelo fique rígida. Se a cirurgia for realizada, a fixação deve ser segura o suficiente para permitir esse movimento precoce. A maioria dos pacientes mantém os implantes após a cirurgia, e apenas 3% experimentam migração do implante. Fatores técnicos do implante são menos importantes do que fatores pessoais ao decidir se uma segunda cirurgia para remoção é necessária.

A cirurgia é considerada quando o tratamento conservador não é adequado ou falhou. Isso é comum em fraturas deslocadas em pacientes jovens e ativos ou naqueles com padrões de lesão complexos. A operação visa manter os fragmentos ósseos no lugar para que possam cicatrizar corretamente. Seu cirurgião escolherá o método que melhor se adapta ao seu tipo específico de fratura e estado de saúde. Seja usando placas, arames ou âncoras, o objetivo é restaurar o mecanismo do tríceps e a função do cotovelo. Em alguns casos com danos graves, a remoção do fragmento quebrado e o reparo do músculo podem ser preferíveis para reduzir complicações. Se você tiver outras lesões, o risco de movimento limitado é maior, portanto, seu cirurgião discutirá isso abertamente. O momento da cirurgia não aumenta significativamente as complicações iniciais, portanto, você pode prosseguir quando estiver pronto.

O que esperar

Seu prognóstico depende em grande parte da sua idade, nível de atividade e se você opta pela cirurgia ou pelo repouso. Para adultos mais velhos ou aqueles com demandas de atividade mais baixas, o manejo não operatório geralmente leva a resultados satisfatórios a curto e longo prazos. Você pode esperar uma função razoável do cotovelo, mesmo que o osso não se una completamente. A maioria dos pacientes deste grupo não solicita cirurgia adicional.

Se você é mais jovem e ativo, a cirurgia é geralmente recomendada para restaurar a força e o movimento. A fixação operatória geralmente fornece excelentes resultados funcionais. Você pode esperar manter os implantes no lugar; apenas 3% dos pacientes apresentam migração do implante. Fatores técnicos são menos importantes do que as escolhas pessoais ao decidir se deseja remover o hardware posteriormente.

A recuperação é um processo gradual. Você pode notar rigidez ou dor surda à medida que a articulação cicatriza. Cerca de 19% dos pacientes desenvolvem osteoartrite pós-traumática, uma condição de desgaste, em um acompanhamento mediano de 41 meses. Isso significa que você pode sentir desconforto ocasional durante mudanças climáticas ou uso intenso. Apesar dessas alterações, uma boa função a longo prazo ainda é possível.

Esteja ciente de que as fraturas do olécrano em idosos apresentam taxas de mortalidade em um ano mais altas do que o esperado. Esse risco é importante a ser discutido com seu cirurgião ao ponderar as opções de tratamento. Se você optar pelo tratamento não operatório para uma fratura deslocada, pode enfrentar uma não união, mas muitos pacientes permanecem satisfeitos com seus resultados.

O momento da cirurgia não aumenta significativamente as complicações iniciais ou a necessidade de reoperação. Você não precisa se apressar para a sala de cirurgia por motivos de segurança, embora a fixação mais precoce possa ajudar no conforto. No geral, a maioria dos pacientes mantém seus implantes e alcança boa função, seja tratada com cirurgia ou repouso cuidadoso.

Quando procurar atendimento

Procure seu médico de família se tiver dor persistente que não melhora com o repouso. Solicite uma avaliação especializada se sentir fraqueza ou instabilidade no cotovelo. Fique atento ao bloqueio ou à sensação de falha da articulação. Procure atendimento se os sintomas interferirem no seu sono ou no trabalho. Entre em contato com seu cirurgião se notar uma piora súbita do seu quadro. Esteja ciente de que a incidência dessas fraturas aumentou 29% durante um período de estudo de 20 anos. A artrite pós-traumática por desgaste ocorre em 19% dos casos, com tempo médio de acompanhamento de 41 meses. Pacientes idosos apresentam taxas de mortalidade em um ano superiores ao esperado. A avaliação precoce ajuda a gerenciar esses riscos de forma eficaz.

Evidence & references

Overview

Non-operative treatment of olecranon fractures in patients aged ≥75 years provided excellent functional results at 6 months without associated complications [1].
Nonoperative management of isolated displaced olecranon fractures in older, lower-demand patients yields satisfactory short-term and long-term outcomes [4].
Evidence offers valuable data for developing personalized treatment plans for olecranon fractures in patients over 75, though it does not definitively settle the debate on operative versus non-operative management [5].
The SOFIE trial is a study protocol aiming to test for superiority of operative versus non-operative treatment for displaced olecranon fractures in the elderly by comparing pain and function up to one year after injury, but it does not report results or conclusions [18].
Low-profile double-plate osteosynthesis is a safe and effective alternative treatment for olecranon fractures with excellent subjective and objective clinical outcome measures [2].
Both Kirschner wire tension band combined with anatomical locking plate and other operative procedures effectively treat Mayo type II olecranon fractures [6].
Plating of the olecranon leads to predictable union, although the most common complication was lack of full extension in 39% of patients [8].
A majority of olecranon fractures heal uneventfully with good/excellent results, with a small loss of motion to be expected [9].
The timing of fixation for displaced olecranon fractures does not significantly increase the rate of early complications or reoperation [13].
Tension band wiring (TBW) remains an effective treatment for appropriately selected olecranon fractures and outperformed plate osteosynthesis in the studied cohort [25].
Suture fixation is the mainstay of treatment for all simple olecranon fractures, with no re-operations or wound complications observed in the series [28].
Surgical treatment of olecranon fractures is associated with a high rate of complications, and patients undergoing revisions beyond implant removal had poorer functional outcomes [58].
No significant differences in functional outcomes or secondary operations were found with respect to fracture type, gender, or surgical method in the context of surgical treatment complications [58].

Anatomy & Pathophysiology

Concomitant injuries in olecranon fractures are associated with a high risk of limited elbow motion [23].
Understanding relevant elbow anatomy and factors associated with stability allows for systematic treatment algorithms that ensure sufficient stability for early motion, leading to improved outcomes [29].
The modified rotational formula (MRCF) provides stable and accurate measurements of rotational displacement despite varying elbow rotations, addressing limitations of the previous method (PRCF) [30].
An anatomic model of terrible triad injury can be created by exerting axial compression on an elbow in 15° flexion and maximal pronation at speeds of 100 and 10 mm/min [33].
Individuals with elbow degenerative changes have no inferior subjective elbow function compared to those with normal radiographs, except in cases with joint space reduction [34].
Elbow range of motion and functional use are maintained in the midterm compared to short-term studies following hemiarthroplasty for distal humeral fractures [35].
The "spin move" is a maneuver that improves exposure of the coronoid process regardless of the degree of elbow instability [36].
Restoration of joint motion in posttraumatic stiff elbows is a difficult, time-consuming, and costly challenge [37].
A portion of the anterior lateral trochlear ridge (aLTR) is covered with articular cartilage but is non-articulating throughout the normal elbow range of motion [41].
Evaluation and management of elbow injuries in young athletes requires knowledge of immature developing anatomy, injury pathophysiology, and established treatment algorithms [44].
Reconstruction of the anterior capsule and ligamentous structures is important for providing stability to the elbow joint in complex fracture-dislocations [45].
Good elbow function can be restored in most cases of comminuted intra-articular distal humeral fractures with minor impairments that do not worsen quality of life [46].
Use of a standard surgical protocol for elbow dislocations with radial head and coronoid fractures restores sufficient stability to allow early postoperative motion, enhancing functional outcomes [47].
Disruptions in forearm structures may lead to forearm instability with consequences at the remaining structures [48].
Open fracture-dislocation (OFD) patterns have the worst functional outcomes among complex elbow injury patterns [51].
Proper treatment of coronoid fractures requires an understanding of the bony and soft tissue anatomy of the elbow and various injury mechanisms [52].
While range of motion is typically preserved after reoperation for intra-articular proximal ulna fractures, 35% of patients experience subsequent complications [53].
Orthogonal plate configuration, olecranon osteotomy, and longer operative time are associated with increased odds of dysfunctional elbow stiffness following operative fixation of distal humerus fractures [54].
Specific patterns of traumatic elbow instability have correspondingly specific coronoid fracture patterns [55].

Classification

The Mayo classification was designed to simplify categorization of olecranon fractures [31].
The Mayo classification does not achieve its goal of simplification due to poor reproducibility [31].
Quantitative 3-dimensional computed tomography analysis clarified the fracture morphology of Mayo type I, II, and III fractures [57].

Clinical Presentation

Olecranon fractures are commonly seen in orthopedic practice [56].
Isolated olecranon fractures occur after low-energy trauma, especially in older women (> 65 years) [16].
Articular impaction is a common feature of geriatric olecranon fractures [19].
Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures [7].
The incidence of olecranon fractures increased by 29% over the 20-year study period (1999–2018) in Denmark [3].
Olecranon fractures in the elderly have higher than expected 1 year mortality rates [14].
More precise studies are needed to properly quantify the specific incidence of various subtypes of forearm and olecranon fractures and associated risk factors [12].

Investigations

The incidence of olecranon fractures increased by 29% over a 20-year study period in Denmark [3].
More precise studies are needed to properly quantify the specific incidence of various subtypes of forearm and olecranon fractures and associated risk factors [12].
Isolated fractures of the olecranon occur after low-energy trauma, especially in older women (> 65 years) [16].
Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures [7].
Olecranon fractures in the elderly have higher than expected 1-year mortality rates [14].
Articular impaction is a common feature of geriatric olecranon fractures [19].

Treatment

Non-Operative Management

Non-operative treatment of olecranon fractures in patients aged ≥75 years provided excellent functional results at 6 months, without associated complications [1].
Nonoperative management of isolated displaced olecranon fractures in older, lower-demand patients yields satisfactory short-term and long-term outcomes [4].
Primary non-operative management is supported for isolated displaced fractures of the olecranon in the elderly [10].
Non-operative treatment of Mayo Type II olecranon fractures may be successful, extending the age range for which such treatment of displaced olecranon fractures can be considered [21].
Patients who present with a non-union after a displaced olecranon fracture managed non-operatively have reasonable elbow function and uncommonly request operative treatment [27].
Nonoperative treatment as a reasonable option is supported for displaced stable olecranon fractures in elderly patients [40].
Displaced olecranon fractures in patients older than 70 years may be effectively managed with nonoperative measures to produce high satisfaction and functional range of motion [49].
Aggregate data support the non-operative treatment of isolated undisplaced olecranon fractures with good results [42].
The literature on the treatment of olecranon fractures in elderly patients is limited [15].
More precise studies are needed in order to properly quantify the specific incidence of various subtypes of forearm and olecranon fractures and associated risk factors [12].
While data offer valuable information for personalized treatment plans, it is not definitively settled whether olecranon fractures should be managed nonoperatively in patients over 75 [5].
The SOFIE study is a protocol testing for superiority of operative versus non-operative treatment and does not report results or conclusions [18].
Surgical management remains the standard of care for displaced olecranon fractures until more convincing evidence supports nonsurgical treatment [39].

Operative Management

Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures [2].
Both Kirschner wire tension band combined with anatomical locking plate and other operative procedures effectively treat Mayo type II olecranon fractures [6].
Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes [11].
In cases with concomitant injuries, the risk of limited elbow motion is high following open reduction and plate osteosynthesis [23].
Double tension band wiring (DTBW) produced good clinical and radiological outcomes and could be an effective option for the treatment of olecranon fractures by providing additional stability through a second tension band wire [24].
Tension band wiring (TBW) remains an effective treatment for appropriately selected olecranon fractures and outperformed plate osteosynthesis in the studied cohort [25].
Both locking-plate osteosynthesis and intramedullary nailing could be appropriate surgical techniques for fixation of selected olecranon fractures and osteotomies [26].
Plate has better efficacy and safety than tension band wire for Mayo II olecranon fractures [32].
The Nickel-Titanium olecranon memory connector (OMC) could be an effective alternative to treat olecranon fractures [38].
Plate fixation of complex olecranon fractures is an effective, reliable method of treatment with low risk of non-union [50].
No one technique is suitable for the management of all olecranon fractures [17].

Complications

Non-operative treatment of olecranon fracture in patients aged ≥75 years provided excellent functional results at 6 months without associated complications [1].
Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures [2].
Nonoperative management of isolated displaced olecranon fractures in older, lower-demand patients yields satisfactory short-term and long-term outcomes [4].
Plating of the olecranon leads to predictable union, though the most common complication was lack of full extension in 39% of patients [8].
A majority of olecranon fractures heal uneventfully with good/excellent results, with a small loss of motion to be expected [9].
Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes [11].
The timing of fixation of displaced olecranon fractures does not significantly increase the rate of early complications or reoperation [13].
Olecranon fractures in the elderly have higher than expected 1 year mortality rates [14].
The median incidence of post-traumatic osteoarthritis following isolated olecranon fractures is 19% at a median follow-up of 41 months [20].
Suture fixation for simple olecranon fractures resulted in no re-operations or wound complications in the studied series [28].
Patients who have operative fixation of a fracture of the olecranon can be counseled that most patients keep their implants [61].
Only 3% of patients experience implant migration after operative fixation of a fracture of the olecranon [61].
Technical factors such as the type or configuration of an implant seem less important than personal factors in determining who requests a second surgery for implant removal after olecranon fracture fixation [61].

Recovery

Non-operative treatment of olecranon fractures in patients aged ≥75 years provided excellent functional results at 6 months, without associated complications [1].
Nonoperative management of isolated displaced olecranon fractures in older, lower-demand patients yields satisfactory short-term and long-term outcomes [4].
Non-operative treatment of Mayo Type II olecranon fractures may be successful, extending the age range for which such treatment of displaced olecranon fractures can be considered [21].
The literature on the treatment of olecranon fractures in elderly patients is limited [15].
Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures [2].
Plating of the olecranon leads to predictable union, though the most common complication was lack of full extension in 39% of patients [8].
Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes [11].
Good functional long-term results are to be expected in patients with complex olecranon fractures treated with open reduction and internal fixation, despite arthritic changes in the elbow joint [43].
A majority of olecranon fractures heal uneventfully with good/excellent results with a small loss of motion to be expected [9].
Among active patients with a simple isolated, displaced fracture of the olecranon, no difference was found between tension-band wire (TBW) and plate fixation in the patient-reported outcome at 1 year following surgery [63].
The timing of fixation of displaced olecranon fractures does not significantly increase the rate of early complications or reoperation [13].
Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures [7].
Olecranon fractures in the elderly have higher than expected 1 year mortality rates [14].
The incidence of post-traumatic osteoarthritis following isolated olecranon fractures has a median incidence of 19% at a median follow-up of 41 months [20].

Key Evidence

[L4] Non-operative treatment of olecranon fracture in patients aged ≥75 years provided excellent functional results at 6 months, without associated complications. [1] (10.1016/j.otsr.2017.10.015)
[L3] Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures. [2] (10.1016/j.otsr.2019.08.019)
[L3] The incidence of olecranon fractures increased by 29% over the 20-year study period. [3] (10.1186/s13018-025-05970-2)
[L4] We found satisfactory short-term and long-term outcomes following the nonoperative management of isolated displaced olecranon fractures in older, lower-demand patients. [4] (10.2106/jbjs.l.01137)
[L2] While they did not definitively settle the debate about whether we should manage olecranon fractures nonoperatively in patients over 75, they did offer valuable data that surgeons and patients can use to develop personalized treatment plans tailored to each patient's needs. [5] (10.2106/jbjs.24.01097)
[L3] Both operative procedures effectively treat Mayo type II olecranon fractures. [6] (10.1186/s12891-025-08843-1)
[L3] Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures. [7] (10.1177/17585732221124301)
[L3] Plating of the olecranon leads to predictable union, though the most common complication was lack of full extension in 39% of patients. [8] (10.1016/j.injury.2016.04.015)
[L4] A majority of olecranon fractures heal uneventfully with good/excellent results with a small loss of motion to be expected. [9] (10.1016/j.hcl.2015.07.003)
[L1] These data further support the role of primary non-operative management of isolated displaced fractures of the olecranon in the elderly. [10] (10.1302/0301-620x.99b7.bjj-2016-1112.r2)
[L4] Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes. [11] (10.5397/cise.2023.00528)
[L3] More precise studies are needed in order to properly quantify the specific incidence of various subtypes of forearm and olecranon fractures and associated risk factors. [12] (10.1186/s12891-023-07162-7)
[L3] The timing of fixation of displaced olecranon fractures does not significantly increase the rate of early complications or reoperation. [13] (10.1016/j.jhsg.2023.09.002)
[L3] Olecranon fractures in the elderly have higher than expected 1 year mortality rates. [14] (10.1177/1758573221994860)
[L4] The literature on the treatment of olecranon fractures in elderly patients is limited. [15] (10.1007/s11678-018-0488-7)
[L4] Isolated fractures of the olecranon occur after a low-energy trauma, especially in older women (> 65 years). [16] (10.1007/s00068-021-01765-2)
[Paper] No one technique is suitable for the management of all olecranon fractures. [17] (10.1016/j.injury.2008.12.013)
[L2] This document is a study protocol and does not report results or conclusions; the study aims to test for superiority of operative treatment versus non-operative treatment for displaced olecranon fractures in the elderly by comparing pain and function up to one year after injury. [18] (10.1186/s12891-015-0789-6)
[L4] Articular impaction is a common feature of geriatric olecranon fractures. [19] (10.5435/jaaos-d-20-01293)
[L4] This review identified a median OA incidence of 19% at a median follow-up of 41 months following isolated olecranon fractures. [20] (10.1016/j.jse.2026.02.024)
[L4] Non-operative treatment of Mayo Type II olecranon fractures may be successful, extending the age range for which such treatment of displaced olecranon fractures can be considered. [21] (10.1177/1758573217711889)
[L4] In cases with concomitant injuries, the risk of limited elbow motion is high. [23] (10.1016/j.jse.2010.11.023)
[L4] DTBW produced good clinical and radiological outcomes and could be an effective option for the treatment of olecranon fractures by providing additional stability through a second TBW. [24] (10.1016/j.jhsa.2014.09.020)
[L4] TBW remains an effective treatment for appropriately selected olecranon fractures and in this cohort outperformed plate osteosynthesis. [25] (10.1007/s00590-015-1724-0)
[L3] Both implant types could be appropriate surgical techniques for fixation of selected olecranon fractures and osteotomies. [26] (10.1007/s00264-013-1854-0)
[L4] Patients who present with a non-union after a displaced olecranon fracture managed non-operatively have reasonable elbow function and uncommonly request operative treatment. [27] (10.1111/j.1758-5740.2012.00194.x)
[L4] Suture fixation is now the mainstay of treatment for all simple olecranon fractures, with no re-operations or wound complications observed in this series. [28] (10.1177/1758573216687305)
[L5] Despite the complexities of this injury, an understanding of the relevant anatomy and the factors associated with elbow stability allows the application of a systematic algorithm for treatment that can help ensure sufficient elbow stability to allow early motion, thereby leading to improved outcomes in most patients. [29] (10.5435/00124635-200903000-00003)
[L5] MRCF effectively addresses the limitations of PRCF and provides stable, accurate measurements of rotational displacement even with varying elbow rotations. [30] (10.1186/s12891-024-08240-0)
[L5] The Mayo classification was designed to simplify categorization of olecranon fractures but does not achieve this goal due to poor reproducibility. [31] (10.1097/corr.0000000000000614)
[L1] Plate has better efficacy and safety for Mayo II olecranon fractures. [32] (10.1186/s13018-022-03262-7)
[L5] The study successfully created and validated an anatomic model of terrible triad of the elbow by exerting axial compression on an elbow in 15° flexion and maximal pronation at speeds of 100 and 10 mm/min. [33] (10.1186/s13018-024-05069-0)
[L3] Individuals with elbow degenerative changes had no inferior subjective elbow function compared to those with normal radiographs, except for those with joint space reduction. [34] (10.1007/s00402-020-03453-z)
[L4] The data suggest that elbow range of motion and functional use are maintained from comparison with short-term studies. [35] (10.1016/j.jse.2016.09.057)
[L5] The spin move is a simple maneuver that can improve exposure of the coronoid process regardless of the degree of elbow instability. [36] (10.1016/j.jse.2022.11.020)
[L4] Restoration of joint motion in the posttraumatic stiff elbow can be a difficult, time-consuming, and costly challenge. [37] (10.1016/j.jhsa.2007.09.015)
[L2] The study showed that OMC could be an effective alternative to treat olecranon fractures. [38] (10.1007/s00264-013-1878-5)
[Letter] The authors of the original review acknowledge that nonsurgical management was limited to nondisplaced fractures due to editorial constraints but maintain that surgical management remains the standard of care for displaced olecranon fractures until more convincing evidence supports nonsurgical treatment. [39] (10.1016/j.jhsa.2013.04.013)
[L1] This supports nonoperative treatment as a reasonable option for displaced stable olecranon fractures in elderly patients. [40] (10.2106/jbjs.24.00655)
[L5] Our results suggest that there is a portion of the aLTR that, despite being covered with articular cartilage, is non-articulating throughout normal elbow range of motion. [41] (10.2106/jbjs.18.01270)
[L4] Aggregate data support the non-operative treatment of isolated undisplaced olecranon fractures with good results, and support the operative treatment of fractures displaced ≥4 mm. [42] (10.1302/2058-5241.5.190082)
[Abstract] Good functional long-term results are to be expected in patients with complex olecranon fractures treated with open reduction and internal fixation, despite arthritic changes in the elbow joint. [43] (10.1016/j.jse.2007.02.092)
[L5] Evaluation and management of elbow injuries in young athletes requires knowledge of the immature developing anatomy, injury pathophysiology, and established treatment algorithms for each diagnosis. [44] (10.1016/j.csm.2010.06.010)
[L4] It is important to reconstruct the anterior capsule and ligamentous structures for providing stability to the elbow joint. [45] (10.1007/s00402-006-0198-2)
[L4] Good elbow function can be restored in most cases with minor impairments that do not worsen quality of life. [46] (10.1016/j.jse.2014.01.017)
[L4] Use of the surgical protocol restored sufficient elbow stability to allow early motion postoperatively, enhancing the functional outcome. [47] (10.2106/jbjs.d.02933)
[L5] Disruptions in any of these structures may lead to forearm instability with consequences at the remaining structures. [48] (10.1016/j.jhsa.2016.10.017)
[L4] Displaced olecranon fractures in patients older than 70 years may be effectively managed with nonoperative measures to produce high satisfaction and functional range of motion. [49] (10.1177/1558944720944261)
[L4] Plate fixation of complex olecranon fracture is an effective, reliable method of treatment with low risk of non-union. [50] (10.1016/j.ijscr.2017.10.052)
[L3] OFD has the worst functional outcomes among complex elbow injury patterns. [51] (10.1016/j.jse.2024.06.004)
[L5] Proper treatment of coronoid fractures requires an understanding of the bony and soft tissue anatomy of the elbow and the various injury mechanisms that occur. [52] (10.1016/j.hcl.2004.07.004)
[L4] While ROM is typically preserved after reoperation and improved when the indication for reoperation is elbow stiffness, a significant proportion of patients (35%) experience subsequent complications. [53] (10.1016/j.jseint.2024.12.017)
[L3] Orthogonal plate configuration, olecranon osteotomy, and longer operative time were associated with increased odds of dysfunctional elbow stiffness. [54] (10.1016/j.jse.2024.06.010)
[L4] Specific patterns of traumatic elbow instability have correspondingly specific coronoid fracture patterns. [55] (10.1016/j.jhsa.2014.06.123)
[L4] Olecranon fractures are commonly seen in orthopedic practice and have good to excellent outcomes with adherence to a treatment algorithm based on displacement, comminution, and joint stability. [56] (10.1016/j.ocl.2008.01.002)
[L4] Quantitative analysis of olecranon fractures further clarified fracture morphology of Mayo type I, II, and III fractures. [57] (10.1016/j.jse.2015.10.002)
[L4] Surgical treatment of olecranon fractures is associated with a high rate of complications, and patients undergoing revisions beyond implant removal had poorer functional outcomes; however, no significant differences in functional outcomes or secondary operations were found with respect to fracture type, gender, or surgical method. [58] (10.1016/j.xrrt.2025.08.004)
[L3] Patients who have operative fixation of a fracture of the olecranon can be counseled that most patients keep their implants, that only 3% experience implant migration, and that technical factors such as the type or configuration of an implant seem less important than personal factors in determining who requests a second surgery for implant removal. [61] (10.1007/s11999-015-4488-2)
[L1] Among active patients with a simple isolated, displaced fracture of the olecranon, no difference was found between TBW and plate fixation in the patient-reported outcome at 1 year following surgery. [63] (10.2106/jbjs.16.00773)

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