Treatment
The treatment of an olecranon fracture is in most cases surgical. Only in the case of non-displaced (non-dislocated) fractures in children can the fracture be treated conservatively, as their bones have another healing ability. In this case, the fracture is immobilised with a Gilchrist or Desault dressing.
Immobilization ensures that the bone parts grow together in a precisely fitting manner. All other fractures, however, must be treated surgically. A distinction is made between simple avulsion fractures, where the olecranon is simply broken through and the upper part is pulled upwards by the triceps muscle, and comminuted fractures, where the olecranon is broken into several parts.
In the treatment of both fractures, access is from the radius (spoke) to protect the ulnar nerve. The important tasks of the ulnar nerve include the sensitive care of parts of the forearm and hand, as well as flexion in the wrist and spreading of the fingers. The avulsion fracture is treated with the aid of tension belt osteosynthesis.In this technique, the tensile forces that pull the bone fragments apart are converted into compressive forces by means of wire loops.
The fractions are thus brought together and held so that they can heal again. In a comminuted fracture, the individual fracture fragments (bone parts) are stabilized by means of plate osteosynthesis. Small plates are used to fix the debris fragments together and hold them in the correct position so that they can grow together.
In both cases, the metal is usually removed in another minor surgical procedure. This is done after 2 months at the earliest. During the period of fracture healing, immobilization may be necessary, depending on the extent of the fracture. Physiotherapeutic exercises can support mobility and counteract a loss of strength.
Prognosis
With adequate medical treatment and the correct choice and execution of the surgical technique, the chances of healing an olecranon fracture are very good. The prognosis essentially depends on the extent of the fracture and the injury to adjacent structures such as vessels, muscles and tendons or nerves. Comminuted fractures can result in irregularities in the joint despite careful surgical treatment.
As a result, this can lead to wear and tear of the articular cartilage (arthrosis) or painful restrictions of movement. This can be problematic in strenuous sports such as tennis, golf or rowing, but does not normally affect the joint in its everyday function. The operation itself can be classified as low-risk, and only rarely does it lead to injury to important structures, inflammation or wound healing disorders.
