鹰嘴骨折

Patients › Elbow

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

Updated Jun 2026

一幅手绘插图，描绘了一个没有面部特征的人摔倒并直接落在弯曲的肘尖上。 — X线显示鹰嘴骨折——肘部的骨性尖端。 Kieran Hirpara 4.0

您的感受

您会在肘部后方感到尖锐的疼痛。这是上臂尖锐的骨头与前臂相接的地方。当您试图在阻力下伸直手臂时，疼痛往往会加剧。您可能会注意到关节周围出现肿胀和瘀伤。提起比一杯咖啡更重的物品可能会很困难。简单的任务，如伸手到背后扣文胸或把衬衫塞进裤子里，会变得非常具有挑战性。

您的肘部可能会感到僵硬，尤其是在早晨刚醒来时。将关节活动到其全部活动范围可能会引起疼痛。您可能会发现很难侧卧在受伤的一侧睡觉。在日常活动使用手臂后，疼痛也可能加重。将手臂支撑起来休息通常能带来一些缓解。然而，让手臂完全静止不动过久会使僵硬加重。

由于骨折涉及关节面，您在活动时可能会感到摩擦感或听到咔哒声。这是因为骨头在应该平滑滑动的地方相互摩擦。在老年人中，这种磨损性关节炎在几年内影响约 19% 的患者。您可能会经历偶尔的酸痛，即使在初始损伤愈合后也会持续存在。这些症状可能会反复发作，通常由天气变化或过度使用触发。

如果您超过 70 岁，您的外科医生可能会讨论非手术选项。这些方法侧重于管理疼痛和维持功能，而不是完美的骨骼对位。许多患者对这种方法表示高度满意，即使骨骼没有在完美的位置愈合。目标是帮助您以最小的不适完成日常任务。您的外科医生将根据您的具体需求和活动水平定制治疗方案。

实际发生了什么

鹰嘴是肘部的骨性尖端，也是你放在桌面上时接触桌面的部位。它是前臂两根骨头之一——尺骨的一部分。当这块骨头骨折时，通常会破坏附着在骨头上的三头肌肌腱，这根肌腱就像一根牢固的绳索连接在骨头上。这种连接使你能对抗重力伸直手臂。如果骨折发生移位，这根“绳索”可能会从骨块上被拉离，导致你难以抬起手或举起物体。

外科医生的主要目标是恢复上臂骨与前臂骨相接处的光滑关节面。这个关节面必须平整，以便骨头之间能够顺畅滑动而不会相互摩擦。如果骨折没有牢固固定，肘关节可能会变得僵硬。早期活动对于预防这种僵硬至关重要。外科医生会选择一种固定方法，既能保持骨头稳定，使你在术后不久就能活动手臂，又能保护正在愈合的骨头。

有时，骨折过于复杂或骨质太差，无法进行标准修复。在这种情况下，外科医生可能会完全移除骨折块，并将三头肌肌腱直接重新附着在前臂骨上。这种方法避免了内固定物带来的并发症，通常能带来更好的功能恢复和更少的疼痛。对于活动需求较低的老年患者，非手术治疗也可能是一个安全有效的选择。

即使治疗成功，随着时间的推移，肘关节仍可能发生磨损性关节炎。数据显示，19% 的患者会发展出这种情况，中位随访时间为 41 个月。这意味着，对部分患者而言，覆盖在骨端的光滑软骨会逐渐磨损，可能在晚年引起疼痛或僵硬。然而，无论接受手术治疗还是保守治疗，大多数患者都能获得良好的长期功能和满意度。

我们能采取的措施

对于许多患者，尤其是老年人或身体活动需求较低者，非手术治疗是一种安全且有效的选择。您的外科医生可能会建议休息、冰敷并使用夹板固定，以保持肘部静止，直至骨骼愈合。这种方法侧重于舒适性和让身体自然愈合，无需手术。研究表明，对于老年人而言，单纯性移位骨折采用此方法通常能获得令人满意的短期和长期结果。您可以期望保持功能性活动范围，并经历轻微疼痛。即使骨骼未能完全愈合（骨不连），许多患者仍能获得合理的肘部功能，且很少在后期要求手术。对于年轻患者或移位明显的患者，手术通常是恢复稳定性的标准方案。

疼痛管理是康复过程中的关键部分。您的外科医生可能会开具止痛药或抗炎药，以帮助您在愈合过程中保持舒适。虽然皮质类固醇、透明质酸或富血小板血浆（PRP）等注射疗法常用于关节疼痛，但针对鹰嘴骨折的证据主要侧重于结构愈合，而非这些特定注射疗法。目标是控制疼痛，以便在安全的情况下尽早开始轻柔活动。早期活动对于防止肘关节僵硬至关重要。如果进行手术，内固定必须足够牢固，以允许这种早期活动。大多数患者在术后保留植入物，仅 3% 的患者出现植入物移位。在决定是否需要二次手术取出植入物时，植入物的技术因素不如个人因素重要。

当保守治疗不适用或失败时，会考虑手术。这在年轻、活跃的患者或损伤模式复杂的患者中较为常见。手术旨在固定骨碎片，使其正确愈合。您的外科医生将根据您的具体骨折类型和健康状况选择最合适的方法。无论是使用钢板、钢丝还是锚钉，目标都是恢复肱三头肌机制和肘部功能。在某些严重损伤的情况下，为了减少并发症，可能会选择移除骨折碎片并修复肌肉。如果您伴有其他损伤，活动受限的风险较高，因此您的外科医生会就此与您充分沟通。手术时机不会显著增加早期并发症的风险，因此您可以在准备好时进行手术。

预期情况

您的预后主要取决于您的年龄、活动水平以及选择手术还是休息。对于老年人或活动需求较低的人群，非手术治疗通常能带来令人满意的短期和长期结果。即使骨骼未完全愈合，您也能获得合理的肘部功能。该组大多数患者不会要求进一步手术。

如果您较年轻且活跃，通常建议手术以恢复力量和活动度。手术固定通常能提供极佳的功能结果。您可以预期保留植入物；仅 3% 的患者会出现植入物移位。在决定是否日后取出硬件时，技术因素的重要性不及个人选择。

恢复是一个渐进的过程。在关节愈合过程中，您可能会感到僵硬或酸痛。在中位随访期为 41 个月时，约 19% 的患者会发展为创伤后骨关节炎，这是一种磨损性疾病。这意味着您在天气变化或过度使用时可能会感到偶尔不适。尽管存在这些变化，但仍有可能获得良好的长期功能。

请注意，老年人的鹰嘴骨折的一年死亡率高于预期。在权衡治疗方案时，这一风险值得与您的外科医生讨论。如果选择对移位骨折进行非手术治疗，您可能会面临骨不连，但许多患者对其结果仍感到满意。

手术时机不会显著增加早期并发症或再次手术的需求。出于安全原因，您无需急于进入手术室，尽管早期固定可能有助于提高舒适度。总体而言，无论接受手术治疗还是谨慎休息，大多数患者都能保留植入物并实现良好的功能。

何时就医

若休息后疼痛仍持续不缓解，请咨询全科医生。若感觉肘部无力或不稳，请要求专科医生评估。注意关节是否出现卡顿或突然失力。若症状干扰睡眠或工作，请寻求医疗帮助。若发现病情突然加重，请联系您的外科医生。请注意，在一项为期20年的研究中，此类骨折的发病率增加了29%。在中位随访期为41个月时，19%的病例会出现创伤后磨损性关节炎。老年患者面临高于预期的一年期死亡率。早期评估有助于有效管理这些风险。

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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