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Fraktura ng Olecranon

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

Updated Jun 2026
Isang guhit-kamay na ilustrasyon ng isang walang mukhang tao na nahuhulog at direktang lumalagok sa puntong bahagi ng kanyang nakabukong siko.
X-ray na nagpapakita ng fracture ng olecranon — ang butong dulo ng siko. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Maramdaman mo ang matulis na sakit sa likod ng iyong siko. Ito ang lugar kung saan nagtatagpo ang matulis na buto ng iyong braso at ang iyong forearms. Karaniwang lumala ang sakit kapag sinusubukan mong tuwidin ang iyong braso laban sa resistensya. Maaaring mapansin mo ang pamamaga at pamumula sa paligid ng kasukasuan. Mahirap itong itaas ang anumang bagay na mas mabigat kaysa sa isang tasa ng kape. Ang mga simpleng gawain tulad ng pag-abot sa likod ng iyong likod upang isara ang bra o pagtupi ng isang damit ay nagiging napakahirap.

Maaaring maramdaman mo ang pagkasiksik ng iyong siko, lalo na kapag gising ka pa lang sa umaga. Ang paggalaw ng kasukasuan sa buong saklaw ng galaw ay maaaring magdulot ng sakit. Maaaring mahirap makatulog sa gilid ng sugat. Maaari ring lumala ang sakit pagkatapos mong gamitin ang iyong braso para sa mga pang-araw-araw na gawain. Ang pagpapahinga habang sinusuportahan ang iyong braso ay madalas na nagdudulot ng kaunting ginhawa. Gayunpaman, ang pagpapanatili ng braso na ganap na tahimik sa loob ng masyadong matagal ay maaaring palalain ang pagkasiksik.

Dahil ang fracture ay kabilang ang ibabaw ng kasukasuan, maaaring maramdaman mo ang pakiramdam ng pagkagiling o marinig ang mga tunog ng pag-click kapag gumagalaw ka. Ito ay dulot ng pagkiskisan ng mga buto sa isa’t isa kung saan dapat itong dumudulas nang maayos. Sa mga mas matandang tao, ang arthritis na ito na dulot ng pagkasira ay aapektado ang mga 19% ng mga pasyente sa loob ng ilang taon. Maaaring maranasan mo ang mga obset na sakit na nananatili matapos na gumaling ang paunang sugat. Ang mga sintomas na ito ay maaaring umalis at bumalik, madalas na pinapukaw ng pagbabago ng panahon o mabigat na paggamit.

Kung ikaw ay higit sa 70 taong gulang, maaaring talakayin ng iyong doktor ang mga opsyon na hindi kailangan ng operasyon. Ang mga pamamaraan na ito ay nakatuon sa pamamahala ng sakit at pagpapanatili ng function sa halip na perpektong pagkakahanay ng buto. Maraming pasyente ang nagsasabing mataas ang kanilang kasiyahan sa pamamaraang ito, kahit hindi gumaling ang buto sa perpektong posisyon. Ang layunin ay tulungan kang makagawa ng mga pang-araw-araw na gawain na may kaunting hindi komportableng pakiramdam. Ang iyong doktor ay mag-aangkop ng plano sa iyong mga partikular na pangangailangan at antas ng aktibidad.

Ano ang nangyayari talaga

Ang olecranon ay ang butong dulo ng iyong siko na iyong inilalagay sa mesa. Ito ay bahagi ng ulna, isa sa dalawang buto ng iyong braso. Kapag nabasag ang butong ito, madalas itong nakakaapekto sa triceps tendon, na gumagana tulad ng matibay na lubid na nakakabit sa buto. Ang koneksyong ito ang nagbibigay-daan sa iyo na tuwidin ang iyong braso laban sa grabidad. Kung ang basag ay may displacement, maaaring umalis ang lubid na ito mula sa piraso ng buto, na nagiging dahilan ng hirap o kawalan ng kakayahang itaas ang iyong kamay o hawakan ang mga bagay.

Ang pangunahing layunin ng iyong doktor ay ibalik ang makinis na ibabaw kung saan ang buto ng iyong itaas na braso ay nagtatagpo sa buto ng iyong ibabang braso. Kailangang pantay ang ibabaw ng kasukasuan na ito upang ang mga buto ay makagalaw nang walang alitan. Kung hindi ayusin nang maayos ang basag, maaaring maging matigas ang iyong siko. Mahalaga ang maagang paggalaw upang maiwasan ang pagiging matigas na ito. Pipiliin ng iyong doktor ang paraan ng pagkukumpuni na sapat na matatag ang buto upang makagalaw ka ng maaga pagkatapos ng operasyon, habang pinoprotektahan pa rin ang nagpapagaling na buto.

Minsan, masyadong kumplikado ang basag o masyadong mahina ang kalidad ng buto para sa karaniwang pagkukumpuni. Sa mga kaso na ito, maaaring tanggalin ng iyong doktor ang basag na piraso nang buo at ikabit muli ang triceps tendon direkta sa buto ng ibabang braso. Ang paraang ito ay nakaiiwas sa mga komplikasyon ng hardware at madalas ay nagdudulot ng mas magandang pagganap na may mas kaunting sakit. Para sa mga mas matandang pasyente na may mas mababang pangangailangan sa aktibidad, maaari ring maging ligtas at epektibong opsyon ang hindi operasyong paggamot.

Kahit sa matagumpay na paggamot, maaaring umusbong ang arthritis na dulot ng pagkasuot sa kasukasuan ng siko sa paglipas ng panahon. Ang datos ay nagpapakita na 19% ng mga pasyente ang nakakakuha ng kondisyong ito, na may median na pagsubaybay na 41 buwan. Ibig sabihin, para sa ilang tao, ang makinis na patong ng cartilage na sumasakop sa mga dulo ng buto ay napapagod, na maaaring magdulot ng sakit o pagiging matigas nang huli sa buhay. Gayunpaman, karamihan sa mga pasyente ay nakakamit ng magandang pangmatagalang pagganap at kasiyahan, anuman kung sila ay nakapagpasok sa operasyon o sa konservatibong pamamahala.

Ano ang maaari naming gawin dito

Para sa maraming pasyente, lalo na ang mga matatanda o ang mga may mababang pangangailangan sa pisikal na gawain, ang pamamaraan ng hindi pagsasagawa ng operasyon (non-operative management) ay isang ligtas at epektibong pagpipilian. Maaaring rekomendahan ng iyong doktor ang pahinga, yelo, at splint upang panatilihing tahimik ang siko habang ang buto ay gumagaling. Ang pamamaraang ito ay nakatuon sa kaginhawaan at pagpapahintulot sa likas na paggaling nang walang operasyon. Ipakita ng mga pag-aaral na ang mga isolated displaced fractures sa mga matatanda ay madalas na nagdudulot ng sapat na maikli at mahabang panahong resulta sa pamamagitan ng paraang ito. Inaasahan mong mapanatili ang functional na saklaw ng galaw at mararanasan ang minimal na sakit. Kahit hindi ganap na magkasama ang buto (non-union), maraming pasyente ang nakakamit pa rin ng makatwirang pag-andar ng siko at bihira nang humingi ng operasyon sa huli. Para sa mga mas batang pasyente o ang mga may malaking displacement, ang operasyon ay madalas na ang pamantayan upang ibalik ang katatagan.

Ang pamamahala ng sakit ay isang mahalagang bahagi ng iyong paggaling. Maaaring magreseta ng gamot pang-alis ng sakit o anti-inflammatory drugs ang iyong doktor upang tulungan kang manatiling komportable sa proseso ng paggaling. Habang ang mga injection tulad ng cortisone, hyaluronic acid, o PRP ay karaniwan para sa sakit ng kasu-kasuan, ang ebidensya para sa olecranon fractures ay pangunahing nakatuon sa structural na paggaling imbes na sa mga partikular na injection na ito. Ang layunin ay kontrolin ang sakit upang magsimula ka ng banayad na galaw sa lalong madaling panahon kapag ligtas na ito. Mahalaga ang maagang galaw upang maiwasan ang pagiging matigas ng kasu-kasuan ng siko. Kung isasagawa ang operasyon, ang fixation ay dapat sapat na matibay upang pahintulutan ang maagang galaw na ito. Karamihan sa mga pasyente ay nananatili ang kanilang implants pagkatapos ng operasyon, at 3% lamang ang nakakaranas ng paglipat ng implant. Ang mga teknikal na aspeto ng implant ay mas kaunti ang kahalagahan kumpara sa mga personal na aspeto sa pagpasya kung kailangan ng pangalawang operasyon para sa pag-alis nito.

Ang operasyon ay itinuturing kapag ang conservative na pag-aalaga ay hindi angkop o nabigo. Ito ay karaniwan para sa displaced fractures sa mga mas batang, aktibong pasyente o ang mga may kumplikadong pattern ng pinsala. Layunin ng operasyon na panatilihin ang mga fragment ng buto sa kanilang posisyon upang sila ay gumaling nang tama. Pipiliin ng iyong doktor ang paraan na pinaka-angkop sa iyong partikular na uri ng fracture at kalagayan ng kalusugan. Maging sa paggamit ng plates, wires, o anchors, ang layunin ay ibalik ang triceps mechanism at pag-andar ng siko. Sa ilang kaso ng malubhang pinsala, maaaring mas mainam na alisin ang basag na fragment at ayusin ang kalamnan upang bawasan ang mga komplikasyon. Kung mayroon kang ibang pinsala, mas mataas ang risk ng limitadong galaw, kaya ang iyong doktor ay talakayin ito nang bukas. Ang timing ng operasyon ay hindi malaki ang epekto sa maagang mga komplikasyon, kaya maaari kang magpatuloy kapag handa ka na.

Ano ang inaasahan

Ang iyong prognosis ay nakadepende sa malaking bahagi sa iyong edad, antas ng aktibidad, at kung pipili ka ng operasyon o pahinga. Para sa mga matatanda o mga may mababang pangangailangan sa aktibidad, ang nonoperative na pamamahala ay madalas na nagdudulot ng masiyahang maikli at pangmatagalang resulta. Maaari kang mag-expect ng makatwirang pag-andar ng siko kahit hindi ganap na magkakabit ang buto. Karamihan sa mga pasyente sa grupong ito ay hindi humihingi ng karagdagang operasyon.

Kung ikaw ay mas bata at aktibo, karaniwang inirerekomenda ang operasyon upang muling mabigyan ng lakas at galaw. Ang operative fixation ay karaniwang nagbibigay ng mahusay na functional na resulta. Maaari kang mag-expect na manatili ang iyong mga implant; tanging 3% ng mga pasyente ang nakakaranas ng paglipat ng implant. Mas maliit ang epekto ng mga teknikal na salik kumpara sa mga personal na pagpili kapag nagdesisyon kung gusto mo o hindi tanggalin ang hardware sa hinaharap.

Ang paggaling ay isang unti-unting proseso. Maaaring mapansin mo ang stiffness o sakit habang gumagaling ang joint. Humigit-kumulang 19% ng mga pasyente ang nakakakuha ng post-traumatic osteoarthritis, isang kondisyon ng pagkasira, sa isang median na follow-up na 41 buwan. Ibig sabihin, maaaring maranasan mo ang obstruksyon sa panahon ng pagbabago ng panahon o matinding paggamit. Sa kabila ng mga pagbabagong ito, posibleng panatilihin pa rin ang mahusay na pangmatagalang pag-andar.

Mag-ingat na ang mga fracture ng olecranon sa mga matatanda ay may mas mataas na one-year mortality rates kaysa inaasahan. Mahalagang talakayin ang risk na ito sa iyong surgeon kapag tinatimbang ang mga opsyon sa paggamot. Kung pipili ka ng nonoperative na alaga para sa isang displaced fracture, maaari kang harapin ang non-union, ngunit maraming pasyente ang nananatiling masaya sa kanilang mga resulta.

Ang timing ng operasyon ay hindi malaki ang epekto sa pagtaas ng mga maagang komplikasyon o pangangailangan para sa reoperation. Hindi mo kailangang magmadali pumasok sa operating room dahil sa mga dahilan sa kaligtasan, bagama't ang mas maagang fixation ay maaaring makatulong sa kaginhawahan. Sa pangkalahatan, karamihan sa mga pasyente ay nananatiling may implant at nakakamit ng mahusay na pag-andar, anuman ang gamit na operasyon o maingat na pahinga.

Kailan pumunta sa doktor

Kumonsulta sa iyong doktor kung mayroon kang patuloy na sakit na hindi gumagaling kahit magpahinga. Humingi ng pagsusuri ng espesyalista kung nararamdaman mo ang kahinaan o kawalan ng katatagan sa siko. Mag-ingat sa pagkakasara o pagkabigay ng kasu-kasuan ng kasukasuan. Humingi ng tulong kung ang mga sintomas ay nakakaapekto sa iyong pagtulog o trabaho. Makipag-ugnayan sa iyong doktor kung napansin mo ang biglaang paglala ng iyong kalagayan. Alamin na ang insidensya ng mga frakturang ito ay tumataas ng 29% sa loob ng 20-taong panahon ng pag-aaral. Ang post-traumatic wear-and-tear arthritis ay nangyayari sa 19% ng mga kaso sa isang median na pagsubaybay ng 41 buwan. Ang mga matatanda ay may mas mataas na antas ng pagkamatay sa loob ng isang taon kumpara sa inaasahan. Ang maagang pagsusuri ay tumutulong upang ma-manage ang mga riskong ito nang epektibo.

Reviewed by AI synthesis (v2) — pending human review · 18 May 2026.

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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)

References

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DOI: 10.2106/jbjs.24.01097 [6] Efficacy evaluation of Kirschner wire tension band combined with anatomical locking plate in the treatment of Mayo type II olecranon fractures. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08843-1 [7] Mortality and subsequent fractures of patients with olecranon fractures compared to other upper extremity osteoporotic fractures. Shoulder & Elbow. 2022. DOI: 10.1177/17585732221124301 [8] Outcomes after plating of olecranon fractures: A multicenter evaluation. Injury. 2016. DOI: 10.1016/j.injury.2016.04.015 [9] Olecranon Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.07.003 [10] Prospective randomised trial of non-operativeversusoperative management of olecranon fractures in the elderly. The Bone & Joint Journal. 2017. DOI: 10.1302/0301-620x.99b7.bjj-2016-1112.r2 [11] Midterm outcomes of suture anchor fixation for displaced olecranon fractures. Clinics in Shoulder and Elbow. 2024. DOI: 10.5397/cise.2023.00528 [12] Trends and projection of forearm fractures including elbow fractures of the Olecranon in Sweden: an analysis of 363 968 fractures using public aggregated data. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-023-07162-7 [13] Timing of Olecranon Fracture Fixation Does Not Affect Early Complication or Reoperation Rates. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2023.09.002 [14] Complications and mortality associated with olecranon fractures in the elderly: a retrospective cohort comparison from a large level one trauma centre. Shoulder & Elbow. 2021. DOI: 10.1177/1758573221994860 [15] Nonoperative treatment of olecranon fractures in the elderly—a systematic review. Obere Extremität. 2018. DOI: 10.1007/s11678-018-0488-7 [16] Epidemiology, classification and treatment of olecranon fractures in adults: an observational study on 2462 fractures from the Swedish Fracture Register. European Journal of Trauma and Emergency Surgery. 2021. DOI: 10.1007/s00068-021-01765-2 [17] Olecranon fractures. Injury. 2009. DOI: 10.1016/j.injury.2008.12.013 [18] SOFIE: Surgery for Olecranon Fractures in the Elderly: a randomised controlled trial of operative versus non-operative treatment. BMC Musculoskeletal Disorders. 2015. DOI: 10.1186/s12891-015-0789-6 [19] Incidence and Management of Articular Impaction in Geriatric Olecranon Fractures. Journal of the American Academy of Orthopaedic Surgeons. 2021. DOI: 10.5435/jaaos-d-20-01293 [20] Incidence of Post-traumatic Osteoarthritis in Olecranon Fractures and the Role of Instability and Comminution in its Development: A Systematic Review. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.02.024 [21] Pilot report: non-operative treatment of Mayo Type II olecranon fractures in any-age adult patient. Shoulder & Elbow. 2017. DOI: 10.1177/1758573217711889 [23] Results of open reduction and plate osteosynthesis in comminuted fracture of the olecranon. Journal of Shoulder and Elbow Surgery. 2011. DOI: 10.1016/j.jse.2010.11.023 [24] Double Tension Band Wiring for Treatment of Olecranon Fractures. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.09.020 [25] Outcome after olecranon fracture repair: Does construct type matter?. European Journal of Orthopaedic Surgery & Traumatology. 2015. DOI: 10.1007/s00590-015-1724-0 [26] Locking-plate osteosynthesis versus intramedullary nailing for fixation of olecranon fractures: a biomechanical study. International Orthopaedics. 2013. DOI: 10.1007/s00264-013-1854-0 [27] Non-union of Non-operatively Treated Displaced Olecranon Fractures. Shoulder & Elbow. 2012. DOI: 10.1111/j.1758-5740.2012.00194.x [28] Tension band suture fixation for olecranon fractures. Shoulder & Elbow. 2017. DOI: 10.1177/1758573216687305 [29] Terrible Triad Injury of the Elbow: Current Concepts. Journal of the American Academy of Orthopaedic Surgeons. 2009. DOI: 10.5435/00124635-200903000-00003 [30] Elbow rotation affects the accuracy of rotational formulas: validation of a modified method. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08240-0 [31] Classifications in Brief: Mayo Classification of Olecranon Fractures. Clinical Orthopaedics & Related Research. 2018. DOI: 10.1097/corr.0000000000000614 [32] Efficacy and safety of tension band wire versus plate for Mayo II olecranon fractures: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2022. DOI: 10.1186/s13018-022-03262-7 [33] Creation of a replicable anatomic model of terrible triad of the elbow. Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-05069-0 [34] Long-term outcomes after different types of Horne and Tanzer olecranon fractures. Archives of Orthopaedic and Trauma Surgery. 2020. DOI: 10.1007/s00402-020-03453-z [35] Hemiarthroplasty for the treatment of distal humeral fractures: midterm clinical results. Journal of Shoulder and Elbow Surgery. 2017. DOI: 10.1016/j.jse.2016.09.057 [36] The spin move to facilitate antegrade coronoid fixation in terrible triad injuries. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2022.11.020 [37] The Posttraumatic Stiff Elbow: A Review of the Literature. The Journal of Hand Surgery. 2007. DOI: 10.1016/j.jhsa.2007.09.015 [38] Design and application of Nickel-Titanium olecranon memory connector in treatment of olecranon fractures: a prospective randomized controlled trial. International Orthopaedics. 2013. DOI: 10.1007/s00264-013-1878-5 [39] Letter Regarding “Olecranon Fractures”. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.04.013 [40] Surgery for Olecranon Fractures in the Elderly (SOFIE). Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.24.00655 [41] Lateral Trochlear Ridge. Journal of Bone and Joint Surgery. 2019. DOI: 10.2106/jbjs.18.01270 [42] Paediatric olecranon fractures: a systematic review. EFORT Open Reviews. 2020. DOI: 10.1302/2058-5241.5.190082 [43] Long Term Outcome Of Surgically Treated Complex Olecranon Fractures. Journal of Shoulder and Elbow Surgery. 2007. DOI: 10.1016/j.jse.2007.02.092 [44] Pediatric Sports Elbow Injuries. Clinics in Sports Medicine. 2010. DOI: 10.1016/j.csm.2010.06.010 [45] Reconstruction of the coronoid process with iliac crest bone graft in complex fracture-dislocation of elbow. Archives of Orthopaedic and Trauma Surgery. 2006. DOI: 10.1007/s00402-006-0198-2 [46] Results of parallel plate fixation of comminuted intra-articular distal humeral fractures. Journal of Shoulder and Elbow Surgery. 2014. DOI: 10.1016/j.jse.2014.01.017 [47] Standard Surgical Protocol to Treat Elbow Dislocations with Radial Head and Coronoid Fractures. Journal of Bone and Joint Surgery. 2005. DOI: 10.2106/jbjs.d.02933 [48] Forearm Instability: Anatomy, Biomechanics, and Treatment Options. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2016.10.017 [49] Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review. HAND. 2020. DOI: 10.1177/1558944720944261 [50] Management of type IIB and IIIB olecranon fractures. Case series. International Journal of Surgery Case Reports. 2017. DOI: 10.1016/j.ijscr.2017.10.052 [51] Three-dimensional quantitative study and functional outcome analysis of coronoid fracture in different elbow injury patterns. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2024.06.004 [52] Fractures of the coronoid process. Hand Clinics. 2004. DOI: 10.1016/j.hcl.2004.07.004 [53] Surgical outcomes after reoperation of intra-articular proximal ulna fractures. JSES International. 2025. 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a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.