MANUAL MINORS
An olecranon fracture affects the proximal part of the ulna, which forms the tip of the elbow. The olecranon is a crucial site for the insertion of the triceps tendon, enabling elbow extension. This type of fracture typically results from direct trauma, such as falls onto the elbow or accidents, or indirectly from sudden triceps contractions.
Symptoms include sharp pain, swelling, inability to extend the elbow, deformity, and possibly abnormal movement at the fracture site.
Diagnosis
Diagnosis is based on a physical examination, where localised pain, swelling, and often an inability to actively extend the arm are observed. Lateral X-rays of the elbow confirm the fracture, its displacement, and the integrity of the joint surfaces. In more complex or comminuted fractures, a CT scan may be required for better fracture assessment.
Differential Diagnosis
Condition | Distinctive Characteristics |
|---|---|
Elbow dislocation | Obvious deformity with displacement of joint surfaces without olecranon fracture. |
Radial head fracture | Localised pain on the lateral side of the elbow, with limited forearm rotation. |
Elbow sprain | Generalised pain without visible fractures on X-rays. |
Supracondylar humerus fracture | Pain over the distal humerus, possible deformity, but no direct olecranon involvement. |
Emergency Management
In the emergency setting, the elbow should be immobilised in partial flexion to prevent further displacement and relieve pain. Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) are given for pain control.
Neurovascular function should be evaluated, as olecranon fractures can compromise nearby nerves and blood vessels. In displaced fractures, unnecessary movement of the arm should be avoided before surgical correction.
Definitive Treatment
Treatment depends on the degree of displacement. Non-displaced or minimally displaced fractures can be treated conservatively with immobilisation in a cast for 4 to 6 weeks.
Displaced or unstable fractures require surgical intervention, using internal fixation techniques such as plates, screws, or tension band wiring. Post-surgery, physiotherapy is essential to restore elbow mobility and strength.
Comments