Olecranon and Radial Head/Neck Fractures Disclosures
Olecranon and Radial Head/Neck Fractures
Frank R. Avilucea, MD Assistant Professor
University of Cincinnati Department of Orthopaedic Surgery
Division of Trauma
Disclosures
? None pertinent to this presentation ? Journal Reviewer
? Journal of Orthopaedic Trauma ? Journal of American Academy of Orthopaedic
Surgeons ? Techniques in Orthopaedics
Olecranon Fractures
Mechanism of Injury ? Rapid Tension Overload: Eccentric contraction
of the triceps with flexion of the elbow ? Direct Trauma ? Chronic Overload: osteopenia, stress fracture
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Olecranon Fractures
Evaluation ? Skin Integrity ? Assess for active elbow
extension ? Neurovascular exam ? Radiographs: AP, lateral,
and oblique
Olecranon Fractures
Treatment Goals ? Restore articular congruity ? Restore elbow extensor mechanism ? Rigid Fixation ? Achieve Stable arc of motion and prevent
stiffness - Begin early range of motion ? Avoid Complications
Olecranon Fractures
Indications for Operative Management ? Disruption of the Extensor Mechanism
- Unable to actively extend ? Articular Incongruity
- Any displaced fracture
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Olecranon Fractures
Treatment Options ? Open Reduction Internal Fixation
- Tension Band - Plate Fixation ? Olecranon Excision and Triceps Advancement
Olecranon Fractures
Positioning ? Lateral Decubitus ? Sterile Tourniquet ? Regional or General ? Direct Posterior Approach ? Padded Mayo
Olecranon Fractures
Reduction
Wires Clamps Mini-Fragment Plates
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Olecranon Fractures
Simple Fractures Tension band or Plate
Olecranon Fractures
Comminuted Olecranon Fractures Plate Fixation
Olecranon Fractures
Olecranon Excision ? Olecranon critical in traumatic elbow instability ? Linear decrease in stability with incremental
excision
An KN. Clin Orthop 209:270-279, 1986
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Olecranon Fractures
Olecranon Excision Osteoporosis ................
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