Olecranon Fracture Info In-depth Evidence
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
What you're feeling
You may feel a sudden, sharp pain at the back of your elbow if you fall onto it or take a heavy blow. Some people hear or feel a snap or pop at that moment. The pain is often intense and immediate. You might notice swelling and bruising appear quickly around the joint. The area can look deformed or feel tender to the touch.
Moving your arm becomes difficult right away. You may find it hard to straighten your arm against gravity because the triceps muscle, which helps you extend your elbow, is affected. Simple tasks like lifting a cup or pushing yourself up from a chair can feel impossible or very painful. You might keep your arm close to your body to avoid moving it.
In the first few days, the pain may be worse at night or when you try to shift positions. Swelling can make the elbow feel tight and stiff. As healing begins over the first few weeks, the sharp pain usually settles into a duller ache. You may still feel discomfort when you bend or straighten your elbow, especially if you try to use it too soon.
It is common to feel frustrated by the loss of function. You might worry about how long it will take to return to normal activities. For some patients, particularly those over 70, non-operative management can lead to satisfactory outcomes with good range of motion. However, the risk of post-traumatic osteoarthritis, or wear-and-tear arthritis, is about 19% at a median follow-up of 41 months. This means some people may experience long-term stiffness or aching in the joint.
Your surgeon will guide you on the best path for your specific injury. Whether you need surgery or rest, the goal is to reduce pain and restore movement. Be patient with your body as it heals. Avoid forcing the elbow to move if it causes sharp pain. Follow the advice given to you to ensure the best possible recovery.
What's actually happening
The olecranon is the bony tip of your elbow. It forms the pointy part you rest on a table. This bone is the anchor for your triceps tendon. This tendon is the strong cable that lets you straighten your arm. When this area breaks, that anchoring system is disrupted.
Think of your elbow like a gate hinge. The olecranon is the latch that keeps the gate closed and stable. If the latch cracks or shifts out of place, the hinge becomes wobbly. You lose the ability to push against resistance. Your arm may feel weak or unstable when you try to lift things.
In many cases, the break is displaced. This means the bone fragments have moved apart. The triceps tendon pulls one piece up, away from the rest of the upper arm bone. This gap prevents the bone from healing in the correct position. Without treatment, the joint surface may become uneven. This can lead to wear-and-tear arthritis over time. The median incidence of post-traumatic osteoarthritis following isolated olecranon fractures is 19% at a median follow-up of 41 months.
Your surgeon aims to restore a smooth, congruent joint surface. This allows your arm to move freely again. The goal is to allow early motion to avoid significant stiffness of the elbow joint. If the break is simple, we often use strong sutures to hold the pieces together. This technique is the mainstay of treatment for all simple olecranon fractures. In some cases, we may remove the broken fragment and reattach the tendon. This approach can result in significantly less morbidity compared with internal fixation.
For older patients with lower physical demands, non-operative management is often supported. You may wear a splint to let the bone heal naturally. Evidence shows this yields satisfactory short-term and long-term outcomes for isolated displaced fractures in older, lower-demand patients. Even if the bone does not fully knit together (non-union), many patients retain reasonable elbow function. Requests for further operative treatment are uncommon in these scenarios.
Complex injuries involving multiple fragments or dislocation require more careful planning. These cases involve complex elbow instability. We must ensure the extensor mechanism remains continuous with the ulnar shaft to maintain overhead elbow extension. The medial and lateral forearm fascia also contribute to this stability. Restoring this alignment is the guiding principle of olecranon fracture treatment. It allows for the restoration of upper extremity function.
What we can do about it
Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. We choose treatment based on how much the bone has moved, whether the joint is stable, and your personal needs. For isolated fractures where the bone pieces have not shifted significantly, or for older patients with lower physical demands, non-operative care is often the right choice. This approach involves wearing a sling, splint, or cast to keep the elbow still while it heals. We monitor your progress with repeat X-rays to ensure the bone stays in the correct position. As the pain settles, we guide you through a staged return to movement with physiotherapy to restore function.
Surgery is recommended from the outset if the fracture is displaced, unstable, or if you have high functional demands that require a reliable elbow. We also consider operative treatment if non-operative care would leave you with unacceptable pain or limited movement. The goal of surgery is to secure the bone fragments firmly so you can start moving your elbow early and avoid stiffness. We discuss these options with you to ensure the plan matches your specific injury and lifestyle. Patients undergoing operative fixation can be counselled that most keep their implants, with only 3% experiencing implant migration.
Both paths share common priorities in the early weeks. We focus on effective pain control to help you rest and sleep. You must protect the injury while it heals, avoiding heavy lifting or forceful pushing. Physiotherapy begins at the right stage to regain strength and range of motion without stressing the healing bone. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment, including history, examination, and imaging where needed, establishes the diagnosis and confirms the best path forward.
What to expect
Your recovery depends on whether you have surgery or rest. If you choose non-operative management, you will likely wear a splint or cast. This path is often suitable for older patients with lower activity levels. You can expect satisfactory function in the short and long term. Some patients who do not have surgery still heal well enough that they do not need an operation later.
If you have surgery, the bone and tendon need time to knit back together. Most patients keep their implants in place, with only 3% experiencing implant migration. The timing of your operation does not significantly increase early complications or the need for reoperation. You will likely notice gradual improvement over weeks to months. Most active patients with simple fractures have similar outcomes at one year regardless of the specific surgical method used.
You should plan for a period of limited elbow use. Daily tasks may feel restricted initially. Return to work and sport varies by your job demands and healing speed. For older patients, displaced fractures can be managed without surgery to achieve high satisfaction and good movement. However, be aware that olecranon fractures in the elderly are associated with higher than expected 1-year mortality rates.
There are risks to both paths. The median incidence of post-traumatic osteoarthritis (wear-and-tear arthritis) following isolated fractures is 19% at a median follow-up of 41 months. This means some stiffness or ache may persist long-term. Non-operative management carries a risk of the bone failing to heal (non-union), though many patients still retain reasonable elbow function. Surgical fixation aims to restore the joint surface, but technical factors are less important than your personal health in determining if you might want the hardware removed later. We focus on getting you back to your daily life safely, monitoring your progress closely throughout this process.
When to see someone
Seek urgent care if you have a visible deformity, an open wound, numbness or tingling, or cannot use your arm. These signs need immediate attention. If pain is not settling, or if swelling and movement are not improving week on week as healing progresses, see your GP or ask for a specialist review. This ensures your recovery stays on track. While most fractures heal well, some people may develop wear-and-tear arthritis in the elbow later on. Your surgeon will monitor your progress closely to manage any changes. Early assessment helps prevent complications and supports a smoother return to daily activities. Trust your instincts about your healing journey.
Advanced reading: the deeper science (optional)
This section goes further than you need for your own treatment decisions. Olecranon fracture is worth the extra reading because of one finding that inverts the usual logic of fracture surgery: in older patients, a displaced fracture of the olecranon can be left unfixed, and the elbow still works.
The displaced fracture that does not need fixing
A fracture through the olecranon separates the triceps from the forearm, so the standard reasoning is that it must be reattached or the elbow cannot be straightened against resistance. In patients older than 70, that reasoning does not hold up. A systematic review found displaced olecranon fractures in this group may be effectively managed non-operatively, producing high satisfaction and a functional range of motion [1].
What is traded is measurable: an extension lag — an inability to fully straighten the elbow — and reduced extension strength. What is avoided is a wound over a subcutaneous bone in thin, often fragile skin, and metalwork under that skin. Since prominent hardware is the commonest reason for a second operation after olecranon fixation, avoiding it removes the commonest complication entirely.
For an older person whose arm is used for daily tasks rather than forceful pushing, an elbow that lacks the last few degrees of extension is a smaller imposition than a wound complication. For a younger or higher-demand patient it is not, which is why the finding is specific to age rather than general.
Where fixation is used, the implant choice has separated
For the common displaced-but-simple pattern, two implants compete: a tension band construct of wires and a plate. Across 827 patients with Mayo type II fractures, plate fixation showed better efficacy and safety than tension band wiring — with the authors noting that few studies were included and that higher-quality randomised trials are still needed [2]. A 2025 review of 472 patients comparing modern fixation techniques against traditional tension band wiring points the same way [3].
This is one of the few places on this site where a technique comparison produces a direction rather than a shrug. It is worth holding lightly given the evidence base the authors themselves flag.
Arthritis develops, and mostly does not matter
Long-term imaging findings can be alarming when reported without context. Following isolated olecranon fractures, the median incidence of post-traumatic osteoarthritis was 19% at a median follow-up of 41 months — and final patient-reported outcomes ranged from good to excellent regardless of fracture type or the presence of arthritis [4].
Both halves of that sentence are load-bearing. Arthritis on a follow-up X-ray after this injury is common. It is also, at this timescale, largely disconnected from how people report their elbow functioning. A radiological finding is not automatically a clinical problem, and it should not be the trigger for further intervention on its own.
References for the advanced reading
- Alvara CA, Biedron G, Dunn JC. Nonoperative management of olecranon fractures in elderly patients: a systematic review. Hand (N Y). 2020;17(4):734-9.
- Jia Y, Liu A, Guo T, Chen J, Yu W, Zhai J. Efficacy and safety of tension band wire versus plate for Mayo II olecranon fractures: a systematic review and meta-analysis. J Orthop Surg Res. 2022;17(1).
- Wang C, Li C. Modern fixation techniques versus traditional tension band wiring for olecranon fractures: a systematic review and meta-analysis. J Orthop Surg Res. 2025;20(1).
- Wiersma JP, de Klerk HH, Priester-Vink S, Doornberg JN, Bhasyam AR, van den Bekerom MP. Incidence of post-traumatic osteoarthritis in olecranon fractures and the role of fracture type: a systematic review. J Shoulder Elbow Surg. 2026.
Evidence & references
This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.
Overview
- Close radiographic follow-up is recommended for nonsurgically treated minimally displaced olecranon fractures in children to monitor for further displacement [1].
- Nonoperative management of isolated displaced olecranon fractures yields satisfactory short-term and long-term outcomes in older, lower-demand patients [7].
- A majority of olecranon fractures heal uneventfully with good or excellent results, with a small loss of motion to be expected [4].
- Operative treatment of closed displaced olecranon fractures via open reduction and internal fixation results in excellent or good outcomes in 96% of individuals up to 25 years after the fracture [2].
- Low-profile double-plate osteosynthesis is a safe and effective alternative treatment for olecranon fractures, providing excellent subjective and objective clinical outcome measures [5].
- Both Kirschner wire tension band combined with anatomical locking plate and other operative procedures effectively treat Mayo type II olecranon fractures [8].
- Plating of the olecranon leads to predictable union, although lack of full extension is the most common complication, occurring in 39% of patients [17].
- Tension-band wiring (TBW) remains an effective treatment for appropriately selected olecranon fractures and outperformed plate osteosynthesis in the evaluated cohort [22].
- Excision of the olecranon fragment with repair of the triceps mechanism is supported as the preferred treatment method due to significantly less morbidity compared with internal fixation [25].
- The timing of fixation for displaced olecranon fractures does not significantly increase the rate of early complications or reoperations [13].
- Surgical treatment of olecranon fractures is associated with a high rate of complications, and patients undergoing revisions beyond implant removal had poorer functional outcomes [39].
- No significant differences in functional outcomes or secondary operations were found with respect to fracture type, gender, or surgical method in the context of olecranon fracture complications [39].
- Olecranon osteotomy represents a useful alternative for the treatment of fractures and nonunions of the distal humerus [41].
Anatomy & Pathophysiology
- Fixation of olecranon fractures must be secure enough to permit early motion to avoid significant stiffness of the elbow joint [10].
- In pediatric olecranon fractures, treatment with a sling resulted in all cases being free of symptoms and having a full range of elbow movement at 3 weeks [11].
- Increasing elbow flexion places the medial elbow in a position to carry a greater amount of load, which may be exacerbated during the final moments of the pitching motion [27].
- Individuals with elbow degenerative changes had no inferior subjective elbow function compared to those with normal radiographs, except for those with joint space reduction [29].
- Primary elbow instability and fracture morphology are prognostic factors for elbow function and development of arthrosis after operative treatment of olecranon fractures [35].
- The outcome of tension-band wiring may be compromised in the presence of elbow instability and associated fractures of the radial head and coronoid [38].
- A pathoanatomic approach using the CURL framework systematically evaluates key injury components (coronoid, ulna, radial head, and ligaments) to guide surgical planning for proximal ulna fracture dislocation [43].
- Accurate diagnosis of complex elbow fracture-dislocations, such as posterior Monteggia fractures and posterior fracture-dislocation of the proximal ulna, helps provide effective treatments and evaluate prognosis [44].
- The guiding principle in surgical techniques for olecranon fractures is to restore a congruent humeroulnar joint and allow restoration of upper extremity function [47].
- Technological advances and improved understanding of functional anatomy have led to an evolution in operative reconstruction of complex proximal ulnar and coronoid fractures [48].
- The proposed novel fragment-specific classification of complex olecranon fractures is anatomically based and considers the deforming forces from ligaments and tendons [49].
- The Subjective Elbow Value (SEV) shows a high correlation to the most commonly used scoring systems for outcome evaluation after elbow injury [51].
- A stable, functional elbow can be restored in most patients with proximal ulna fractures treated with open reduction and internal fixation [52].
- Targeting the proximal ulna's narrowest segment provides an effective approach for osteotomy when precise morphology is unknown [53].
- Radiographic measurements of normal elbows guide the surgeon to obtain a more reliable length of the olecranon and maintain articular geometry during fixation [54].
Classification
- The Mayo classification was designed to simplify categorization of olecranon fractures but does not achieve this goal due to poor reproducibility [26].
- Quantitative 3-dimensional computed tomography analysis further clarified the fracture morphology of Mayo type I, II, and III fractures [36].
- Fracture of the olecranon in a child is often only part of a complex injury to the bone and soft tissues around the elbow [19].
- The olecranon apophyseal ossification system, when combined with age and sex, successfully predicts peak height velocity within a year in 90% of cases, establishing a single lateral view of the olecranon as a simple alternative to more complex grading systems [40].
Clinical Presentation
- Olecranon fractures in children can displace further after initial nonsurgical treatment, necessitating close radiographic follow-up [1].
- Isolated displaced olecranon fractures (>2 mm) in elderly patients can be successfully treated nonoperatively [3].
- The incidence of olecranon fractures increased by 29% over a 20-year study period (1999–2018) in Denmark [6].
- Nonoperative management of isolated displaced olecranon fractures in older, lower-demand patients yields satisfactory short-term and long-term outcomes [7].
- Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures [9].
- All 10 pediatric cases treated with a sling were free of symptoms and had a full range of elbow movement at 3 weeks [11].
- Olecranon fractures in the elderly have higher than expected 1-year mortality rates [14].
- Isolated fractures of the olecranon occur after low-energy trauma, especially in older women (>65 years) [15].
- Fractures of the olecranon in children are often part of a complex injury to the bone and soft tissues around the elbow [19].
- Articular impaction is a common feature of geriatric olecranon fractures [20].
- The median incidence of post-traumatic osteoarthritis following isolated olecranon fractures is 19% at a median follow-up of 41 months [21].
Investigations
- Close radiographic follow-up is recommended for nonsurgically treated olecranon fractures [1].
- Some isolated displaced (>2 mm) olecranon fractures in elderly patients can be successfully treated nonoperatively [3].
- Olecranon stress fracture is an overuse injury primarily affecting throwing athletes, with MRI serving as the gold standard for detection [50].
Treatment
Nonoperative Management
- The literature on the treatment of olecranon fractures in elderly patients is limited [18].
- Nonoperative treatment is a reasonable option for displaced stable olecranon fractures in elderly patients [31].
- 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 [34].
- Aggregate data support the non-operative treatment of isolated undisplaced olecranon fractures with good results in pediatric patients [33].
Operative Management
- A majority of olecranon fractures heal uneventfully with good/excellent results with a small loss of motion to be expected [4].
- 96% of individuals with a closed displaced fracture of the olecranon treated by open reduction and internal fixation had excellent or good outcomes up to 25 years after the fracture [2].
- Fixation must be secure enough to permit early motion to avoid significant stiffness of the elbow joint [10].
- No one technique is suitable for the management of all olecranon fractures [16].
- Aggregate data support the operative treatment of pediatric olecranon fractures displaced ≥4 mm [33].
- Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures [5].
- Low-profile double-plate osteosynthesis for treating olecranon fractures resulted in good clinical outcomes [37].
- Tension band wiring (TBW) remains an effective treatment for appropriately selected olecranon fractures and outperformed plate osteosynthesis in the studied cohort [22].
- Internal fixation by cable pin system (CPS) is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications and better function than TBW [23].
- Plate has better efficacy and safety for Mayo II olecranon fractures [28].
- The nickel-titanium olecranon memory connector (OMC) could be an effective alternative to treat olecranon fractures [30].
- Excision of the fragment of the olecranon with repair of the triceps mechanism is supported as the preferred method of treatment of fractures of the olecranon due to significantly less morbidity compared with internal fixation [25].
Complications
- Close radiographic follow-up is recommended for nonsurgically treated olecranon fractures to monitor for further displacement [1].
- Minimally displaced olecranon fractures in children can undergo further displacement after initial nonsurgical treatment [1].
- A majority of olecranon fractures heal uneventfully with good or excellent results, though a small loss of motion is expected [4].
- Olecranon fractures in children treated with a sling result in full range of elbow movement and freedom from symptoms at 3 weeks [11].
- The most common complication after plating of olecranon fractures is lack of full extension, occurring in 39% of patients [17].
- Plating of the olecranon leads to predictable union [17].
- The incidence of post-traumatic osteoarthritis following isolated olecranon fractures has a median rate of 19% at a median follow-up of 41 months [21].
- Instability and comminution play a role in the development of post-traumatic osteoarthritis in olecranon fractures [21].
- Olecranon fractures in the elderly are associated with higher than expected 1-year mortality rates [14].
- Patients aged 50 years or more with an olecranon fracture should be evaluated for osteoporosis and fracture risks for secondary prevention [46].
Recovery
- All 10 cases of pediatric olecranon fractures treated with a sling were free of symptoms and had a full range of elbow movement at 3 weeks [11].
- Internal fixation by cable pin system (CPS) is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications, and better function than tension band wiring (TBW) [23].
- The timing of fixation of displaced olecranon fractures does not significantly increase the rate of early complications or reoperation [13].
Key Evidence
- [L4] Close radiographic follow-up for nonsurgically treated olecranon fractures is recommended. [1] (10.5435/jaaos-d-25-00821)
- [L3] 96% of individuals with a closed displaced fracture of the olecranon treated by open reduction and internal fixation had excellent or good outcomes up to 25 years after the fracture. [2] (10.1067/mse.2002.124548)
- [L4] Some isolated displaced (>2 mm) olecranon fractures in elderly patients can be successfully treated nonoperatively. [3] (10.1016/j.ocl.2016.08.011)
- [L4] A majority of olecranon fractures heal uneventfully with good/excellent results with a small loss of motion to be expected. [4] (10.1016/j.hcl.2015.07.003)
- [L3] Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures. [5] (10.1016/j.otsr.2019.08.019)
- [L3] The incidence of olecranon fractures increased by 29% over the 20-year study period. [6] (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. [7] (10.2106/jbjs.l.01137)
- [L3] Both operative procedures effectively treat Mayo type II olecranon fractures. [8] (10.1186/s12891-025-08843-1)
- [L3] Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures. [9] (10.1177/17585732221124301)
- [L5] Fixation must be secure enough to permit early motion to avoid significant stiffness of the elbow joint. [10] (10.5435/00124635-200007000-00007)
- [L4] All 10 cases treated with a sling were free of symptoms and had a full range of elbow movement at 3 weeks. [11] (10.1016/0020-1383(75)90056-x)
- [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] Isolated fractures of the olecranon occur after a low-energy trauma, especially in older women (> 65 years). [15] (10.1007/s00068-021-01765-2)
- [Paper] No one technique is suitable for the management of all olecranon fractures. [16] (10.1016/j.injury.2008.12.013)
- [L3] Plating of the olecranon leads to predictable union, though the most common complication was lack of full extension in 39% of patients. [17] (10.1016/j.injury.2016.04.015)
- [L4] The literature on the treatment of olecranon fractures in elderly patients is limited. [18] (10.1007/s11678-018-0488-7)
- [L4] Fracture of the olecranon in a child is often only part of a complex injury to the bone and soft tissues around the elbow. [19] (10.1016/0020-1383(80)90009-1)
- [L4] Articular impaction is a common feature of geriatric olecranon fractures. [20] (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. [21] (10.1016/j.jse.2026.02.024)
- [L4] TBW remains an effective treatment for appropriately selected olecranon fractures and in this cohort outperformed plate osteosynthesis. [22] (10.1007/s00590-015-1724-0)
- [L1] Internal fixation by CPS is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications and better function than TBW. [23] (10.1177/147323001204000324)
- [L3] The study supports the rationale for excision of the fragment of the olecranon with repair of the triceps mechanism as the preferred method of treatment of fractures of the olecranon due to significantly less morbidity compared with internal fixation. [25] (10.2106/00004623-198163050-00005)
- [L5] The Mayo classification was designed to simplify categorization of olecranon fractures but does not achieve this goal due to poor reproducibility. [26] (10.1097/corr.0000000000000614)
- [L4] Increasing elbow flexion has been shown to place the medial elbow in a position to carry a greater amount of load, which may be exacerbated during the final moments of the pitching motion. [27] (10.1177/03635465211072223)
- [L1] Plate has better efficacy and safety for Mayo II olecranon fractures. [28] (10.1186/s13018-022-03262-7)
- [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. [29] (10.1007/s00402-020-03453-z)
- [L2] The study showed that OMC could be an effective alternative to treat olecranon fractures. [30] (10.1007/s00264-013-1878-5)
- [L1] This supports nonoperative treatment as a reasonable option for displaced stable olecranon fractures in elderly patients. [31] (10.2106/jbjs.24.00655)
- [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. [33] (10.1302/2058-5241.5.190082)
- [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. [34] (10.1177/1558944720944261)
- [L3] Primary elbow instability and fracture morphology are prognostic factors for elbow function and development of arthrosis after operative treatment of olecranon fractures. [35] (10.1016/j.injury.2003.12.002)
- [L4] Quantitative analysis of olecranon fractures further clarified fracture morphology of Mayo type I, II, and III fractures. [36] (10.1016/j.jse.2015.10.002)
- [L3] Low-profile double-plate osteosynthesis for treating olecranon fractures resulted in good clinical outcomes. [37] (10.1016/j.jse.2020.01.091)
- [L4] However, the outcome may be compromised in the presence of elbow instability and associated fractures of the radial head and coronoid. [38] (10.1016/j.jse.2005.08.002)
- [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. [39] (10.1016/j.xrrt.2025.08.004)
- [L3] When combined with age and sex, the olecranon system successfully predicts PHV within a year in 90% of cases, establishing a single lateral view of the olecranon as a simple alternative to more complex grading systems. [40] (10.2106/jbjs.20.01856)
- [L4] Olecranon osteotomy represents a useful alternative in the treatment of fractures and nonunions of the distal humerus. [41] (10.1097/00005131-200408000-00010)
- [L5] The authors propose a pathoanatomic approach using the CURL framework to systematically evaluate key injury components (coronoid, ulna, radial head, and ligaments) to guide surgical planning and improve outcomes. [43] (10.1177/17585732251348668)
- [L4] Accurate diagnoses of these complex elbow fracture-dislocation help doctors to provide effective treatments and evaluate prognosis. [44] (10.1111/os.12784)
- [L4] Our results suggest that patients aged 50 years or more with olecranon fracture should be evaluated for osteoporosis and fracture risks for secondary prevention of subsequent fractures. [46] (10.11005/jbm.2017.24.3.175)
- [L5] The guiding principle is to restore a congruent humeroulnar joint and allow restoration of upper extremity function. [47] (10.1016/j.jhsa.2014.05.014)
- [Paper] Technological advances and improved understanding of functional anatomy have led to an evolution in operative reconstruction of complex proximal ulnar and coronoid fractures. [48] (10.1016/j.injury.2016.07.060)
- [L4] This proposed classification system is anatomically based and considers the deforming forces from ligaments and tendons. [49] (10.1016/j.jse.2023.12.021)
- [L5] Olecranon stress fracture is an overuse injury primarily affecting throwing athletes, with MRI serving as the gold standard for detection. [50] (10.1016/j.csm.2020.02.005)
- [L4] The SEV shows a high correlation to the most commonly used scoring systems for outcome evaluation after elbow injury. [51] (10.1055/a-0946-2649)
- [L3] A stable, functional elbow can be restored in most patients with proximal ulna fractures treated with open reduction and internal fixation. [52] (10.1007/s00590-015-1628-z)
- [L5] Targeting the proximal ulna's narrowest segment provides an effective approach for osteotomy when precise morphology is unknown. [53] (10.1016/j.jse.2024.12.012)
- [L4] The authors conclude that these measurements guide the surgeon to obtain a more reliable length of the olecranon and maintain articular geometry during fixation. [54] (10.1002/ca.20431)
References
[1] Further Displacement After Initial Nonsurgical Treatment of Minimally Displaced Olecranon Fractures in Children. Journal of the American Academy of Orthopaedic Surgeons. 2026. DOI: 10.5435/jaaos-d-25-00821
[2] Comparison of tension-band and figure-of-eight wiring techniques for treatment of olecranon fractures. Journal of Shoulder and Elbow Surgery. 2002. DOI: 10.1067/mse.2002.124548
[3] Controversies in Fractures of the Proximal Ulna. Orthopedic Clinics of North America. 2017. DOI: 10.1016/j.ocl.2016.08.011
[4] Olecranon Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.07.003
[5] Clinical evaluation of double-plate osteosynthesis for olecranon fractures: A retrospective case-control study. Orthopaedics & Traumatology: Surgery & Research. 2019. DOI: 10.1016/j.otsr.2019.08.019
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