Olecrenon Fracture
What is it: A fracture of the olecranon process, the part of the ulna that comprises a large portion of the posterior elbow.
How does it present: Patients will often present after injury to or fall onto the elbow with pain, swelling and ecchymosis and likely some decreased range of motion due to pain or hemarthrosis.
Common exam findings: Exam will likely show tenderness over the posterior elbow. The ulnar nerve lies between the olecrenon and medial epicondyle and can be injured with an olecrenon fracture. Likewise, the triceps tendon attaches to the posterior portion of the olecranon and can be injured. Therefore, it is important to document a good neurovascular and functional exam of the injured extremity.
Tests and treatment: X-rays are needed to confirm the diagnosis, and the lateral view may be most helpful. Often times referral to orthopedics is indicated for surgical management of these fractures, but some non-displaced fractures can be treated conservatively with a posterior splint for immobilization. Close attention must be made to alignment and stability of the fracture to ensure the best functional results. If any ulnar nerve or triceps injury is suspected, urgent referral to orthopedics is indicated.