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اولیکرانن فریکچر

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

Updated Sep 2026
ایک ہاتھ سے کھینچی گئی تصویر جس میں ایک بے چہرہ شخص گر رہا ہے اور سیدھے اپنے جھکے ہوئے کہنی کی نوک پر اتر رہا ہے۔
ایکس رے جس میں اولیکرانن کی ٹوٹ پھوٹ دکھائی دے رہی ہے کہنی کا بونڈ ٹپ۔ Kieran Hirpara 4.0

اس صفحے کا ترجمہ مشین سے کیا گیا ہے اور ابھی تک کسی ڈاکٹر نے اس کی جانچ نہیں کی۔ انگریزی نسخہ ہی مستند ہے۔

آپ کیا محسوس کر رہے ہیں

ایک اولیکرانن فریکچر آپ کے کوہنی کے مقام پر ٹوٹنا ہے، ہڈی کی نوک جسے آپ پیچھے سے محسوس کر سکتے ہیں۔ یہ عام طور پر کہنی پر گرنے یا براہ راست دستک سے ہوتا ہے۔ کبھی کبھی مزاحمت کے خلاف بازو کا اچانک، زور زور سے سیدھا ہونا ٹپ پر ہڈی کا ایک ٹکڑا کھینچ لیتا ہے۔

فوراً، آپ کو اپنے کوہنی کے پچھلے حصے میں درد محسوس ہوگا۔ یہ علاقہ اکثر بہت زیادہ پھول جاتا ہے، اور جلد کے نیچے سیال جمع ہو سکتا ہے جو کہ کہ کہنی کے اوپر تک پہنچ جاتا ہے۔ چونکہ یہ ہڈی جلد کے بالکل نیچے واقع ہے، آپ سوجن کے ذریعے ٹوٹنے کو محسوس کر سکتے ہیں۔ آپ کے بازو میں چوٹ لگ سکتی ہے، اور آپ شاید کہنی کو موڑنے یا سیدھا کرنے میں ہچکچاتے ہوں گے۔

اگر ٹوٹنے سے ٹکڑا اپنی جگہ سے ہٹ جاتا ہے تو آپ کے بازو کو کشش ثقل کے خلاف سیدھا کرنا مشکل یا ناممکن ہوجاتا ہے۔ آپ کے بازو کے پچھلے حصے کا عضلہ عام طور پر اس ہڈی کی نوک سے لنگر انداز ہوتا ہے، اور جب لنگر ٹوٹ جاتا ہے تو وہ مناسب طریقے سے نہیں کھینچ سکتا۔ آپ کو کوہنی کے پچھلے حصے میں ایک خلا یا شکل میں تبدیلی محسوس ہوسکتی ہے۔

پہلے دنوں میں، درد اکثر نقل و حرکت اور رات کے وقت بدترین ہوتا ہے. آسان چیزیں جیسے کپ تک پہنچنا، کپڑے پہننا، یا اپنے کوہنی پر سہارا لینا تکلیف دے گا۔ اس بازو پر سونے غیر آرام دہ ہے.

پہلے ہفتوں کے دوران ، درد آہستہ آہستہ کم ہوتا ہے کیونکہ ہڈی بننا شروع ہوجاتی ہے۔ کچھ سختی عام ہے، اور ہڈی کے ٹھیک ہونے کے بعد بھی مکمل سیدھا ہونے کا تھوڑا سا نقصان باقی رہ سکتا ہے۔ زیادہ تر ٹوٹنے بغیر کسی پریشانی کے ٹھیک ہوجاتے ہیں۔

آپ کا سرجن آپ کے پورے بازو کا کندھے سے ہاتھ تک معائنہ کرے گا، کیونکہ کہنی جلد کے بالکل نیچے ہوتی ہے اور جلد ہی زخمی ہو سکتی ہے۔ دو زاویوں سے ایکس رے عام طور پر ٹوٹنے کو واضح طور پر ظاہر کرتے ہیں۔ اگر ٹوٹنا پیچیدہ ہے، تو سی ٹی اسکین، جو ایک تفصیلی اسکین ہے، ٹکڑوں کا نمونہ زیادہ واضح طور پر دکھا سکتا ہے، حالانکہ یہ زیادہ تر ٹوٹنے کے لئے ضروری نہیں ہے۔

اگر آپ کی کہنی کھینچی اور ٹوٹی ہوئی ہے تو اسے دوبارہ اپنی جگہ پر رکھنے کے بعد ایک بار پھر ایکس رے لیا جاتا ہے۔

اصل میں کیا ہو رہا ہے

آپ کے کوہنی کی نوک ہڈی کا ایک ٹکڑا ہے جو ایک جھولی کی ٹوپی کی طرح کام کرتی ہے۔ یہ اس کے اوپر بازو کی ہڈی کے ایک سرے کے ارد گرد لپیٹتا ہے اور جب آپ جھکتے اور سیدھے ہوتے ہیں تو وہاں ایک نالی میں گھومتا ہے۔ یہ ہڈی کی نوک آپ کے بازو کے پچھلے حصے میں موجود پٹھوں کی رسی کے لئے بھی اینکر پوائنٹ ہے، جو آپ کے کوہنی کو سیدھا کرتی ہے۔

ہڈی جلد کے بالکل نیچے ہوتی ہے اور کوئی چیز اسے چھپاتی نہیں ہے، اس لیے ٹھوکر یا گرنے سے ہڈی آسانی سے ٹوٹ سکتی ہے۔ جب یہ ٹوٹ جاتا ہے، تو تندور ٹوٹے ہوئے ٹکڑے پر کھینچتا رہتا ہے۔ یہ کھینچنا ٹکڑے کو اوپر اور جگہ سے باہر کھینچتا ہے، ہموار مشترکہ سطح میں ایک خلا چھوڑتا ہے. جب لنگر ٹوٹ جاتا ہے تو ، عضلات اب آپ کی کہنی کو کشش ثقل کے خلاف سیدھا نہیں کرسکتے ہیں۔ ایک دروازے کے جھولے کے بارے میں سوچیں جس کا ایک ٹکڑا اس کے کام کرنے والے لیور سے ٹوٹ گیا ہو: یہ جھولہ پھر بھی چل سکتا ہے، لیکن لیور کو پکڑنے کے لیے کوئی ٹھوس چیز نہیں ہے۔

ٹوٹنا خود ٹھیک ہو جاتا ہے جس طرح کوئی ٹوٹی ہڈی ٹھیک ہوتی ہے۔ دو کناروں ہفتوں کے دوران نئی ہڈی کے ساتھ مل کر باندھتے ہیں. اگر ایک ٹوٹا ہوا ٹکڑا اس کے بستر سے دور کھینچا گیا ہے، تو اسے بنے ہوئے ہونے کے لئے اب بھی اور قریب رکھنے کی ضرورت ہے، اور کبھی کبھی اسے پلیٹوں، تاروں یا مضبوط سلائیوں کے ساتھ وہاں رکھنے کی ضرورت ہوتی ہے.

ہر چھٹی ایک جیسی نہیں ہوتی۔ کچھ پھٹے ہوئے ہیں لیکن پھر بھی قطار میں ہیں۔ کچھ کو اپنی جگہ سے ہٹا دیا جاتا ہے۔ کچھ لوگ کہنی کے جوڑ کو غیر مستحکم چھوڑ دیتے ہیں۔ بریک جو لائن میں رہتے ہیں اکثر آپریشن کے بغیر ہی آباد ہوجاتے ہیں، جبکہ بریک جو کئی ٹکڑوں میں منتقل ہوجاتے ہیں، یا مشترکہ غیر مستحکم چھوڑ دیتے ہیں عام طور پر ان کو واپس رکھنے اور ان کو برقرار رکھنے کے لئے سرجری کی ضرورت ہوتی ہے.

ان میں سے زیادہ تر ٹوٹنے خود بخود ہوتے ہیں، لیکن ایک ہی گرنے سے بازو کے دیگر حصوں کو چوٹ پہنچ سکتی ہے، اور کہنی کے اوپر کی جلد ہڈی سے پھاڑ دی جا سکتی ہے۔ آپ کا سرجن دونوں کی جانچ کرے گا۔

ہم اس کے بارے میں کیا کر سکتے ہیں

ڈاکٹر کیران ہیرپارا، میٹر پرائیویٹ ہسپتال راک ہیمپٹن میں اوپری ٹانگوں کے سرجن، آپ کی مخصوص چوٹ کے مطابق علاج کرتے ہیں۔ مریضوں کو عام طور پر ان کے جی پی کے ذریعہ ہمارے کلینک کا حوالہ دیا جاتا ہے۔ اگر کسی فزیوتھراپسٹ نے آپ کو ہمارے پاس آنے کی تجویز دی ہے تو ، آپ کو میڈیکیئر چھوٹ کے اہل ہونے کے ل your اپنے جی پی سے ریفرل کی ضرورت ہوگی۔ اس پہلے دورے پر ہم ایک تاریخ لیتے ہیں، آپ کے بازو کا معائنہ کرتے ہیں، اور ایکس رے یا سی ٹی اسکین کا استعمال کرتے ہیں جہاں ان کی ضرورت ہوتی ہے ٹوٹنے کے پیٹرن کو کام کرنے کے لئے.

کچھ وقفے قطار میں رہتے ہیں یا مشکل سے جگہ سے ہٹ جاتے ہیں، اور کچھ لوگوں کو دیگر صحت کے مسائل ہیں جو آپریشن کو خراب فٹ بناتے ہیں. ان کے لئے، ہم آپریشن کے بغیر ٹوٹنے کا علاج تجویز کر سکتے ہیں. عام طور پر اس کا مطلب یہ ہوتا ہے کہ جب تک ہڈی بنتی ہے اس وقت تک کہنی کو روکنے کے لیے ایک پٹی، پٹی یا گلاس کا استعمال کیا جائے۔ اس کے ساتھ ساتھ اس بات کو یقینی بنانے کے لیے کہ کچھ بھی حرکت نہ کرے، راستے میں ایکس رے کی جانچ پڑتال کی جائے۔ فزیوتھراپی کے ساتھ مرحلے میں تحریک کو واپس لایا جاتا ہے ایک بار جب وقفہ تیار ہو جاتا ہے. یہ راستہ خاص طور پر بوڑھے، کم فعال لوگوں کے لئے موزوں ہے، اور یہ کام کر سکتا ہے یہاں تک کہ جب وقفہ تھوڑا سا جگہ سے باہر ہے.

دوسرے وقفے شروع سے ہی آپریشن کی ضرورت ہوتی ہے. اگر ٹکڑا اچھی طرح سے اپنی جگہ سے نکالا گیا ہے، اگر کہنی کا جوڑ غیر مستحکم ہے، یا اگر ٹوٹنے والے ٹکڑے کئی ٹکڑوں میں ہیں، تو ایک آپریشن ٹکڑوں کو واپس رکھتا ہے اور انہیں وہاں رکھتا ہے تاکہ ہڈی صحیح پوزیشن میں بنائی جا سکے۔ اس کی مرمت بھی اتنی مضبوط ہونی چاہیے کہ آپ جلد حرکت شروع کر سکیں، جو کہ کہنی کو سخت ہونے سے روکنے میں مدد دیتی ہے۔ زیادہ تر لوگ جو اس ٹوٹنے کے لئے سرجری کرتے ہیں وہ اچھی طرح سے کرتے ہیں، اگرچہ مکمل سیدھا ہونے کا ایک چھوٹا سا نقصان عام ہے اور بعض اوقات دھات کے سامان کو بعد میں نکالنے کی ضرورت ہوتی ہے کیونکہ اس سے تکلیف ہوتی ہے۔ انتخاب واقعی مشترک ہے: بوڑھے لوگوں میں کچھ وقفوں کے لیے، کوئی بھی راستہ کام کر سکتا ہے، اور فیصلہ اس بات پر منحصر ہے کہ آپ کتنی تکلیف برداشت کرنے کے لیے تیار ہیں اور آپ کی کہنی کہاں ختم ہوتی ہے۔

آپ جو بھی راستہ اختیار کریں گے، پہلے ہفتے ایک جیسے ہوں گے۔ درد سے نجات آپ کو آرام دہ رکھتا ہے جبکہ سوجن بیٹھ جاتا ہے. آپ کے بازو کی حفاظت جبکہ ہڈی بناوٹ، ہم آپ کو دے حدود کے بعد. فزیوتھراپی آپ کی چوٹ کے لئے صحیح مرحلے پر شروع ہوتی ہے، آہستہ آہستہ نقل و حرکت کو بحال کرتی ہے۔ ہم آپ کو راستے میں دیکھیں گے ٹوٹنے کی جانچ پڑتال کے طور پر یہ ہونا چاہئے شفا ہے.

کیا توقع کریں

ان میں سے زیادہ تر ٹوٹنے اچھی طرح سے شفا دیتے ہیں. ہڈی کئی ہفتوں میں بنتی ہے، اور درد اس کے ساتھ ساتھ ختم ہو جاتا ہے. زیادہ تر لوگ کام کرنے والی کہنی کے ساتھ ختم ہوجاتے ہیں ، حالانکہ مکمل سیدھے ہونے کا ایک چھوٹا سا نقصان عام ہے اور عام طور پر روزمرہ کی زندگی میں تھوڑی پریشانی کا سبب بنتا ہے۔

اگر آپ کے ٹوٹنے کا علاج سرجری کے بغیر کیا جاتا ہے، تو آپ پٹی، سپلنٹ یا گلاس پہنیں گے جب کہ ہڈی بنائی جاتی ہے، اور ایکس رے کی جانچ پڑتال کے لیے آئیں گے تاکہ یہ یقینی بنایا جا سکے کہ کچھ بھی نہیں ہٹتا ہے۔ اس راستے پر عمر رسیدہ افراد کے لئے، چھ ماہ کی عمر میں کام عام طور پر اچھا ہوتا ہے، اور بریک پیچیدگیوں کے بغیر شفا دے سکتا ہے. اہم خطرہ یہ ہے کہ ٹکڑے جوتے بننے سے پہلے ہی حرکت میں آجائیں، اس لیے ہم انہیں قریب سے دیکھتے ہیں۔

اگر آپ کا آپریشن ہے، تو ٹکڑے ٹکڑے مضبوطی سے ایک ساتھ رکھے جاتے ہیں تاکہ ہڈی صحیح پوزیشن میں بن سکتی ہے، اور پلیٹنگ قابل اعتماد شفا یابی کی طرف جاتا ہے. زیادہ تر لوگ ہفتوں کے اندر اندر نقل و حرکت اور روزمرہ کے کاموں کا انتظام کر رہے ہیں ، فزیوتھراپی کے ساتھ اگلے مہینوں میں زیادہ بحالی ہوتی ہے۔ طویل عرصے میں، اس طرح سے علاج کرنے والے 96٪ لوگوں کو اچھی یا بہت اچھی کہنی کی تقریب کی اطلاع دی گئی ہے، جس کے نتائج کو چوٹ کے بعد 25 سال تک ٹریک کیا جاتا ہے.

بحالی ہمیشہ ہموار نہیں ہوتی۔ سرجری کے بعد سب سے عام مسئلہ مکمل سیدھا نہ ہونا ہے، جو پلیٹ والے 39 فیصد لوگوں میں ہوتا ہے۔ دھات کا سامان جلد کے بالکل نیچے بیٹھ جاتا ہے، اور یہ کبھی کبھی اتنی تکلیف کا سبب بنتا ہے کہ بعد میں اسے ہٹایا جائے۔ اگر کوہنی کو حرکت میں نہ رکھا جائے تو اس میں سختی پیدا ہوسکتی ہے، اور چوٹ کے بعد کے سالوں میں جوڑوں میں آرتھرائٹس ظاہر ہوسکتی ہے، خاص طور پر جب ٹوٹنے کے کئی ٹکڑے ہوتے ہیں۔

بچوں کے لئے ، بغیر سرجری کے علاج کیے جانے والے وقفوں کو قریب سے ایکس رے فالو اپ کی ضرورت ہوتی ہے ، کیونکہ علاج شروع ہونے کے بعد ٹکڑے ٹکڑے ہوسکتے ہیں۔ ایک بچے میں ٹوٹنا اکثر کہنی کے ارد گرد ایک زیادہ پیچیدہ چوٹ کا حصہ ہوتا ہے، لہذا پورے بازو کو احتیاط سے چیک کیا جاتا ہے۔

عمر رسیدہ افراد کو کوہنی سے زیادہ خطرات کا سامنا کرنا پڑتا ہے۔ بزرگوں میں اس قسم کے فریکچر میں پہلے سال میں متوقع سے زیادہ اموات کی شرح ہوتی ہے، جس کی ایک وجہ یہ ہے کہ ہم کسی بھی راستے کی سفارش کرنے سے پہلے دوسرے صحت کے مسائل کے خلاف احتیاط سے سرجری کا وزن کرتے ہیں۔

کسی سے کب ملنا ہے

اگر آپ کے کوہنی کی شکل بدلی ہوئی نظر آتی ہے، جلد ٹوٹی ہوئی ہے، آپ کو بے حسی یا جھنجھٹ محسوس ہوتی ہے، یا آپ اپنے بازو کو استعمال نہیں کر سکتے تو فوری طور پر طبی امداد حاصل کریں۔ زیادہ تر دیگر وقفوں کے لئے، اپنے جی پی کے ساتھ شروع کریں، جو ایکس رے کا بندوبست کرسکتے ہیں اور اگر ضرورت ہو تو آپ کو حوالہ دیتے ہیں. ایک بار علاج شروع ہونے کے بعد، ہفتے کی طرف سے چیزوں کی پیشرفت پر نظر رکھیں. اگر درد ختم نہیں ہوتا ہے، یا اگر سوجن، تحریک یا روزمرہ کی تقریب ایک ہفتے سے اگلے میں بہتر نہیں ہوتی ہے تو اپنے ڈاکٹر یا ایک ماہر جائزہ لینے کے لئے پوچھیں. آپ جو محسوس کرتے ہیں اس پر بھروسہ کریں: آہستہ آہستہ پیش رفت معمول کی بات ہے، لیکن کسی بھی طرح کی کوئی پیش رفت چیک کرنے کے قابل نہیں ہے۔

مزید گہرائی میں

یہ سیکشن آپ کے اپنے علاج کے فیصلوں کے لئے ضرورت سے زیادہ جاتا ہے. اولیکرانن فریکچر اضافی پڑھنے کے قابل ہے کیونکہ ایک دریافت جو فریکچر سرجری کی معمول کی منطق کو الٹ دیتی ہے: بوڑھے مریضوں میں ، اولیکرانن کا ایک بے گھر فریکچر غیر فکسڈ چھوڑا جاسکتا ہے ، اور کہنی اب بھی کام کرتی ہے۔

بے گھر شدہ فریکچر جس کو ٹھیک کرنے کی ضرورت نہیں ہے

اولیکرانون کے ذریعے ٹوٹنے سے ٹرائسیپس کو ماتھے سے الگ کر دیا جاتا ہے، لہذا معیاری استدلال یہ ہے کہ اسے دوبارہ جوڑا جانا چاہیے یا رکاوٹ کے خلاف کہنی کو سیدھا نہیں کیا جا سکتا۔ مریضوں میں 70 سال سے زیادہ عمر، یہ استدلال درست نہیں ہے۔ ایک منظم جائزہ میں اس گروپ میں بے گھر olecranon فریکچر پایا غیر آپریشنل طور پر مؤثر طریقے سے منظم کیا جا سکتا ہے، اعلی اطمینان اور تحریک کی ایک فنکشنل رینج پیدا [1].

جو تجارت کی جاتی ہے وہ قابل پیمائش ہے: ایکسٹینشن کی تاخیر، کہنی کو مکمل طور پر سیدھا کرنے کی نااہلی، اور ایکسٹینشن کی کم طاقت۔ کیا بچایا جاتا ہے پتلی، اکثر نازک جلد میں ایک subcutaneous ہڈی پر ایک زخم ہے، اور اس جلد کے نیچے دھات کا کام. چونکہ اولیکرانون فکسشن کے بعد ایک دوسرے آپریشن کے لئے نمایاں ہارڈ ویئر سب سے عام وجہ ہے ، اس سے گریز کرنا سب سے عام پیچیدگی کو مکمل طور پر ختم کرتا ہے۔

ایک بوڑھے شخص کے لئے جس کا بازو روزمرہ کے کاموں کے لئے استعمال ہوتا ہے بجائے زور زور سے دھکا دینے کے ، ایک کوہنی جس میں توسیع کی آخری چند ڈگریوں کی کمی ہوتی ہے وہ زخم کی پیچیدگی کے مقابلے میں ایک چھوٹا سا فرض ہے۔ ایک نوجوان یا زیادہ مطالبہ کرنے والے مریض کے لئے یہ نہیں ہے ، یہی وجہ ہے کہ یہ نتیجہ عام کی بجائے عمر کے لئے مخصوص ہے۔

جہاں فکسشن استعمال کیا جاتا ہے، امپلانٹ کا انتخاب الگ الگ ہے

مشترکہ بے گھر لیکن سادہ نمونہ کے لئے ، دو امپلانٹس مقابلہ کرتے ہیں: تاروں اور ایک پلیٹ کی ایک تناؤ بینڈ تعمیر۔ اس پار 827 مییو ٹائپ II فریکچر کے مریضوں میں پلیٹ فکسشن نے بہتر کارکردگی اور حفاظت کا مظاہرہ کیا ٹینشن بینڈ کی وائرنگ کے مقابلے میں، مصنفین نے نوٹ کیا کہ کچھ مطالعہ شامل تھے اور یہ کہ اعلی معیار کے بے ترتیب ٹرائلز اب بھی ضروری ہیں [2]- جی ہاں . 2025 کا جائزہ 472 روایتی تناؤ بینڈ وائرنگ پوائنٹس کے خلاف جدید فکسشن تکنیک کا موازنہ کرنے والے مریض اسی طرح [3].

یہ اس سائٹ پر چند جگہوں میں سے ایک ہے جہاں ایک تکنیک کے مقابلے میں ایک سمت کی بجائے ایک shrug پیدا ہوتا ہے. مصنفین خود پرچم ثبوت کی بنیاد کو دیکھتے ہوئے ہلکا پھلکا رکھنے کے قابل ہے.

آرتھرائٹس کی ترقی، اور زیادہ تر کوئی فرق نہیں پڑتا

طویل مدتی امیجنگ کے نتائج پریشان کن ہوسکتے ہیں جب سیاق و سباق کے بغیر اطلاع دی جاتی ہے۔ الگ تھلگ olecranon فریکچر کے بعد، 41 ماہ کی اوسط فالو اپ کے بعد پوسٹ ٹرامٹک آسٹیوآرتھرائٹس کی درمیانی شرح 19 فیصد تھی۔، اور فریکچر کی قسم یا گٹھیا کی موجودگی سے قطع نظر مریضوں کی طرف سے رپورٹ کردہ حتمی نتائج اچھے سے عمدہ تک تھے [4].

اس جملے کے دونوں حصّے بوجھ برداشت کرنے والے ہیں۔ اس چوٹ کے بعد ایک فالو اپ ایکس رے پر گٹھیا عام ہے. یہ بھی، اس وقت کے پیمانے پر، بڑے پیمانے پر لوگوں کو ان کی کہنی کی تقریب کی رپورٹ سے منسلک نہیں ہے. ایک ریڈیولوجیکل تلاش خود بخود ایک کلینیکل مسئلہ نہیں ہے، اور یہ خود کو مزید مداخلت کے لئے ٹرگر نہیں ہونا چاہئے.

حوالہ جات

[1] Alvara CA، Biedron G، ڈن JC. بزرگ مریضوں میں olecranon فریکچر کے غیر آپریشنل انتظام: ایک منظم جائزہ. ہاتھ (این وائی) ۔ 2020;17(4):734-9. https://doi.org/10.1177/1558944720944261

[2] جیا ی، لیو اے، گو ٹی، چن جی، یو ڈبلیو، ژائی جی. Mayo II olecranon فریکچر کے لئے کشیدگی بینڈ تار بمقابلہ پلیٹ کی افادیت اور حفاظت: ایک منظم جائزہ اور میٹا تجزیہ. J آرتھوپک سرجری ریزولوشن 2022؛17(1). https://doi.org/10.1186/s13018-022-03262-7

[3] وانگ سی، لی سی. جدید فکسشن تکنیک بمقابلہ روایتی تناؤ بینڈ وائرنگ کے لئے olecranon فریکچر: ایک منظم جائزہ اور میٹا تجزیہ. J آرتھوپک سرجری ریزولوشن 2025؛20(1). https://doi.org/10.1186/s13018-025-06061-y

[4] ویرسما جے پی ، ڈی کلرک ایچ ایچ ، پریسٹر ونک ایس ، ڈورنبرگ جے این ، بھاشیم اے آر ، وان ڈین بیکروم ایم پی۔ اولیکرانن فریکچر میں پوسٹ ٹرامٹک آسٹیوآرتھرائٹس کے واقعات اور فریکچر کی قسم کا کردار: ایک منظم جائزہ۔ جی کندھے کوہنی سرجری 2026۔ https://doi.org/10.1016/j.jse.2026.02.024


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Close radiographic follow-up is recommended for nonsurgically treated olecranon fractures in children [1].
  • 96% of individuals with a closed displaced fracture of the olecranon treated by open reduction and internal fixation had excellent or good outcomes up to 25 years after the fracture [2].
  • A majority of olecranon fractures heal uneventfully with good or excellent results, with a small loss of motion to be expected [4].
  • Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures [5].
  • Satisfactory short-term and long-term outcomes were found following the nonoperative management of isolated displaced olecranon fractures in older, lower-demand patients [7].
  • Future studies should focus on the long-term outcomes of suture tension band fixation as compared to traditional and more established techniques to treat olecranon fractures [8].
  • Both Kirschner wire tension band and anatomical locking plate operative procedures effectively treat Mayo type II olecranon fractures [11].
  • Plating of the olecranon leads to predictable union, though the most common complication was lack of full extension in 39% of patients [19].
  • The timing of fixation of displaced olecranon fractures does not significantly increase the rate of early complications or reoperation [24].
  • Tension-band wiring remains an effective treatment for appropriately selected olecranon fractures and outperformed plate osteosynthesis in the studied cohort [34].
  • Surgical treatment of olecranon fractures is associated with a high rate of complications [63].
  • Patients undergoing revisions beyond implant removal had poorer functional outcomes after surgical treatment of olecranon fractures [63].
  • No significant differences in functional outcomes or secondary operations were found with respect to fracture type, gender, or surgical method in the treatment of olecranon fractures [63].

Anatomy & Pathophysiology

Bony Anatomy

  • The olecranon and the coronoid process form the greater sigmoid notch, which articulates with the trochlea of the distal humerus [21].
  • The intrinsic anatomy of the ulnohumeral articulation allows flexion/extension movement of the elbow joint and provides stability for the elbow [21].
  • The olecranon serves as the insertion for the triceps tendon, which blends with the periosteum of the proximal ulna [21].
  • The exposed, subcutaneous position of the olecranon renders it vulnerable to direct trauma and violent muscular contractions from the triceps [21].
  • In children, the olecranon is predominantly cartilage, particularly in younger patients, which reduces the likelihood of fracture from a direct blow [29].
  • In children, the thick periosteum and relatively thin metaphyseal cortex of the olecranon predispose the bone to minimally displaced greenstick fractures [29].

Mechanisms of Injury

  • Olecranon fractures can result from a direct blow, a fall on an outstretched hand with the elbow in flexion, or high-energy trauma associated with radial head fractures or elbow dislocation [21].
  • Sudden and violent triceps muscle contraction can produce an avulsion fracture of varying size at the olecranon tip [21].
  • A bimodal distribution of olecranon fractures is observed in young patients with high-energy trauma and elderly patients with low-energy trauma such as a fall from standing [21].
  • In older patients, olecranon fractures typically occur as low-energy falls from standing, while in younger patients they typically occur via high-energy injury mechanisms [22].
  • Regardless of the mechanism of injury, the triceps acts as the main deforming mechanism pulling the fractured fragment proximally, creating a gap at the articular surface and an incompetent extensor mechanism [22].
  • In pediatric patients, olecranon fractures are usually the result of a hyperextension injury [29].
  • Pediatric olecranon fractures may also be caused by a direct blow to the flexed elbow, hyperflexion injury, or shear force [29].
  • Valgus hyperextension forces in pediatric patients may produce an associated radial neck or medial epicondyle fracture [29].
  • Varus hyperextension injuries in pediatric patients may be associated with lateral dislocation of the radial head or a Bado type III Monteggia lesion [29].
  • Flexion injuries in pediatric patients are usually caused by a fall on an outstretched hand with the elbow flexed, resulting from a strong eccentric contraction of the triceps [29].
  • Pediatric flexion injuries are generally transverse (perpendicular to the axis of the ulna), displaced posteriorly rather than anteriorly, and rarely associated with other injuries [29].
  • Shear injuries in pediatric patients result from a force to the proximal ulna just anterior to the humeral condyles, causing the olecranon to fracture through metaphyseal bone with anterior displacement of the distal fragment [29].

Associated Injuries and Epidemiology

  • Olecranon fractures account for approximately 5% of elbow fractures in pediatric patients [29].
  • Pediatric olecranon fractures are associated with other elbow injuries, usually the medial epicondyle, in 20% to 50% of cases [29].
  • In adults, olecranon fractures typically occur in isolation, but 22% of patients had injuries to the ipsilateral limb and 6.4% of fractures were open in one epidemiologic study [22].
  • Olecranon fractures compose approximately 10% of all fractures around the elbow [32].
  • In a Swedish Fracture Register study of 2,462 fractures, 29% were comminuted central fractures and the share of distal olecranon fractures was almost threefold larger than the 6.2% reported in a Scottish study [9].
  • In the Swedish Fracture Register study, 87.4% of female patients and 77.8% of male patients overall sustained low-energy injuries [9].

Fracture Patterns and Classification

  • Displaced olecranon fracture lines enter along the medial side of the trochlear notch and exit at the base of the coronoid, while minimally displaced fractures enter and exit the trochlear notch at the base of the coronoid [22].
  • The Mayo classification of olecranon fractures is based on the amount of fracture displacement, the presence of comminution, and stability of the ulnohumeral joint [22].
  • In the Mayo classification, Type I fractures are nondisplaced, Type II fractures are displaced, and Type III fractures have an unstable ulnohumeral joint [22].
  • The modifier A (simple) and B (comminuted) in the Mayo classification indicate the presence of comminution [22].
  • The Schatzker and Colton classification attempted to classify olecranon fractures based on different fracture pattern morphology, but its application was limited [22].
  • A proposed fragment-specific classification system for complex olecranon fractures is anatomically based and considers the deforming forces from ligaments and tendons [36].

Classification

Epidemiology and Demographics

  • The incidence of olecranon fractures increased by 29% over a 20-year study period in Denmark [6].
  • Olecranon fractures show a bimodal distribution, occurring in younger patients due to high-energy trauma and in elderly cohorts with low bone quality after low-energy falls [60].
  • In a Swedish study of 2,462 fractures, high-energy injuries were more common in males (11.6%) than females (5.7%), while low-energy injuries were more common in females (87.4%) than males (77.8%) [9].
  • In a UK study of 64 olecranon fractures, the mean age was 57 years, with males fracturing at a significantly younger mean age (50 years) than females (63 years) [66].
  • Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures [12].
  • More precise studies are needed to properly quantify the specific incidence of various subtypes of forearm and olecranon fractures and associated risk factors [15].

Classification Systems

  • The Mayo classification is the most commonly used in clinical practice for olecranon fractures [28].
  • The Mayo classification consists of 3 types, with a modifier to indicate comminution [28].
  • In the Mayo classification, Type I fractures are nondisplaced, Type II fractures are displaced, and Type III fractures have accompanying injuries [28].
  • The Mayo classification specifically accounts for fracture stability as well as comminution [27].
  • In the Mayo classification, Type 1 is not displaced and stable, Type 2 is displaced but stable, and Type 3 is displaced and unstable [27].
  • Each Mayo type can be subdivided into subtype A (non-comminuted) or B (comminuted) [27].
  • The Mayo classification was designed to simplify categorization of olecranon fractures but does not achieve this goal due to poor reproducibility [38].
  • Multiple classification systems for olecranon fractures exist, including AO, Mayo, Schatzker and Colton, but none are widely accepted or provide direct and reliable advice on operative strategies [60].
  • The low reproducibility rates of olecranon fracture classification systems raise questions about their use in clinical and research contexts [60].
  • Schatzker and Colton divide olecranon fractures into groups by quantity of fragments and fracture lines [60].
  • The AO classification subsumes olecranon fractures to proximal forearm injuries [60].
  • Quantitative analysis of olecranon fractures further clarified fracture morphology of Mayo type I, II, and III fractures [57].
  • A proposed novel classification system for complex olecranon fractures is anatomically based and considers the deforming forces from ligaments and tendons [36].

Fracture Patterns and Distribution

  • In a Swedish study of 2,462 fractures, comminuted central fractures accounted for 29% of cases [9].
  • The share of distal olecranon fractures in a Swedish nationwide study was almost threefold larger than the 6.2% reported in a Scottish single-center study [9].
  • In a UK study of 64 olecranon fractures, the most frequent injury according to the AO fracture classification was the 21-B1.1 type [66].
  • In a UK study of 64 olecranon fractures, a simple isolated displaced olecranon fracture (Mayo type 2A) was the most common according to the Mayo classification [66].
  • In a UK study of 64 olecranon fractures, Mayo type 2A fractures accounted for 73.5% of cases [66].
  • In a UK study of 64 olecranon fractures, Mayo type 1A fractures accounted for 12.5% of cases [66].
  • In a UK study of 64 olecranon fractures, Mayo type 2B fractures accounted for 7.8% of cases [66].
  • In a UK study of 64 olecranon fractures, Mayo type 3A and 3B fractures each accounted for 3.1% of cases [66].
  • Fracture of the olecranon in a child is often only part of a complex injury to the bone and soft tissues around the elbow [16].

Clinical Presentation

Mechanisms and Epidemiology

  • Sudden and violent triceps muscle contraction can produce an avulsion fracture of varying size of the olecranon tip [21].
  • A bimodal distribution of olecranon fractures is seen in young patients with high-energy trauma and elderly patients with low-energy trauma such as a fall from standing [21].
  • The incidence of olecranon fractures increased by 29% over the 20-year study period from 1999 to 2018 in Denmark [6].
  • In a Swedish study of patients aged 65 years and below, high-energy injury mechanisms accounted for 10.3% of female and 15.9% of male cases, while low-energy mechanisms accounted for 81.8% of female and 73.2% of male cases [9].
  • In a Swedish study of patients older than 65 years, high-energy injury mechanisms accounted for 2.4% of female and 4.1% of male cases, while low-energy mechanisms accounted for 91.2% of female and 85.8% of male cases [9].
  • Olecranon fractures in the elderly have higher than expected 1 year mortality rates [25].

Physical Examination

  • Pain is usually localized to the posterior part of the elbow [21].
  • Given the subcutaneous location of the olecranon, the fracture itself may be palpable [21].
  • Extensive posterior swelling is typical [21].
  • A careful examination of the integrity of the extensor mechanism with gravity eliminated can aid surgical decision making [21].
  • Open wounds, if present, are typically posterior and result from the direct impact of the posterior surface of the elbow against an unyielding structure [21].
  • The affected extremity from shoulder to hand should be thoroughly examined due to a significant incidence of associated ipsilateral injuries [22].
  • The arm should be examined for soft tissue compromise, and clinicians should have a low suspicion for open fractures given the subcutaneous nature of the olecranon [22].
  • The elbow will often present with a large fluid collection subcutaneously over the olecranon [22].
  • Examination of the extensor mechanism both with and without gravity eliminated should be performed to assess competency [22].
  • In an epidemiologic study, 22% of patients with olecranon fractures had injuries to the ipsilateral limb and 6.4% of fractures were open [22].
  • Olecranon fractures in children are usually undisplaced and incomplete, with the 'longitudinal split' fracture being not uncommon [20].

Imaging

  • Plain radiographs are usually sufficient for isolated fractures of the olecranon [21].
  • A true lateral radiograph is necessary to accurately identify the plane of the fracture and the number of fracture fragments [21].
  • The examiner should assess for fracture comminution and impaction on radiographs [21].
  • In more complex cases, CT may help delineate comminution or impaction better, but this is not routinely required [21].
  • Anteroposterior and lateral radiographs of the elbow are required for olecranon fractures [22].
  • If there is concern for a radial head fracture, a radiocapitellar view of the elbow can be obtained [22].
  • In the setting of an elbow dislocation, post-reduction radiographs should be obtained [22].
  • Computed tomography (CT) can be used for preoperative planning for comminuted fractures of the olecranon if there is an associated radial head or coronoid fracture, but this is not routinely utilized [22].
  • Articular impaction is a common feature of geriatric olecranon fractures [50].

Classification

  • The Mayo classification is the most common classification used for olecranon fractures [22].
  • The Mayo classification is based on the amount of fracture displacement, the presence of comminution, and stability of the ulnohumeral joint [22].
  • The Mayo classification is simple to use, can help guide fracture management, and has good interobserver reliability [22].
  • Displaced olecranon fracture lines entered along the medial side of the trochlear notch and exited at the base of the coronoid, while minimally displaced fractures entered and exited the trochlear notch at the base of the coronoid [22].
  • In a Swedish study, 29% of olecranon fractures were comminuted central fractures [9].
  • The share of distal olecranon fractures in the Swedish study was almost threefold larger than the 6.2% reported in a Scottish study of 64 olecranon fractures [9].

Investigations

Imaging

  • In more complex cases, CT may help delineate the comminution or impaction better, but this is not routinely required [21].
  • Radiographic evaluation generally analyzes the fracture based on the percentage of articular surface involved in the fractured proximal fragment [32].
  • The amount of comminution, fracture angle, intraarticular step-off, degree of displacement, and patient comorbidities and functional demands are critical in evaluating the injury and selecting treatment [32].

Physical Examination

  • If present, open wounds are typically posterior and result from the direct impact of the posterior surface of the elbow against an unyielding structure [21].
  • The affected extremity from shoulder to hand should be thoroughly examined [22].
  • The arm should be examined for any soft tissue compromise, and one should have a low suspicion for open fractures given the subcutaneous nature of the olecranon [22].
  • Pain usually is localized to the posterior part of the elbow [21].
  • The history may help distinguish a triceps avulsion from an actual direct blow to the elbow [21].

Classification

  • The Colton classification system can aid in decision making regarding treatment options [21].
  • In a Swedish study of 2,462 fractures, the distribution of fractures differed compared to a single-center report from Scotland, with a larger share of comminuted central fractures (29%) [9].
  • The Swedish study observed an almost threefold larger share of distal olecranon fractures than the 6.2% reported in the Scottish study of 64 olecranon fractures [9].

Treatment

Non-Operative Management

  • Some isolated displaced (>2 mm) olecranon fractures in elderly patients can be successfully treated nonoperatively [3].
  • The literature on the treatment of olecranon fractures in elderly patients is limited [26].
  • Nonoperative treatment is supported as a reasonable option for displaced stable olecranon fractures in elderly patients [49].
  • 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 [53].

Operative Management

  • Fixation must be secure enough to permit early motion to avoid significant stiffness of the elbow joint [10].
  • Both operative procedures (Kirschner wire tension band combined with anatomical locking plate) effectively treat Mayo type II olecranon fractures [11].
  • No one technique is suitable for the management of all olecranon fractures [18].
  • The majority of olecranon fractures are treated surgically [28].
  • Good results overall are to be expected after surgical management of olecranon fractures [28].
  • Tension band wiring (TBW) remains an effective treatment for appropriately selected olecranon fractures and outperformed plate osteosynthesis in the studied cohort [34].
  • Plate fixation has better efficacy and safety for Mayo II olecranon fractures [42].
  • Nickel-Titanium olecranon memory connector (OMC) can be an effective alternative to treat olecranon fractures [47].
  • Internal fixation by cable pin system (CPS) is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications and better function than tension band wiring (TBW) [51].
  • Low-profile double-plate osteosynthesis for treating olecranon fractures resulted in good clinical outcomes [58].

Outcomes and General Considerations

  • Although some loss of range of motion is common, good results overall are to be expected after surgical management [28].
  • Symptomatic hardware requiring removal is a recurring and frequent problem in olecranon fracture treatment [28].

Complications

General Outcomes and Mortality

Hardware and Surgical Complications

  • Symptomatic hardware requiring removal is a recurring and frequent problem following surgical management of olecranon fractures [28].

Joint Degeneration and Motion

  • The incidence of ulnohumeral osteoarthritis following isolated olecranon fractures is assessed using classifications such as Broberg and Morrey, where grade 1 or higher is considered to have osteoarthritis [27].
  • The role of comminution in the development of ulnohumeral osteoarthritis is assessed by comparing non-comminuted (type A) with comminuted (type B) fractures [27].
  • The role of instability in the development of ulnohumeral osteoarthritis is assessed by comparing displaced but stable (type 2) with displaced and unstable (type 3) fractures [27].

Pediatric and Specific Populations

  • Close radiographic follow-up for nonsurgically treated olecranon fractures is recommended in children to monitor for further displacement [1].

Recovery

  • The incidence of ulnohumeral osteoarthritis following isolated olecranon fractures was determined using the Broberg and Morrey classification, where grade 1 or higher is considered to have osteoarthritis [27].
  • The role of comminution in the development of ulnohumeral osteoarthritis was assessed by comparing Mayo type A (non-comminuted) with type B (comminuted) fractures [27].
  • The role of instability in the development of ulnohumeral osteoarthritis was assessed by comparing Mayo type 2 (displaced but stable) with type 3 (displaced and unstable) fractures [27].

Key Evidence

  • [L4] Close radiographic follow-up for nonsurgically treated olecranon fractures is recommended. [1] (10.5435/jaaos-d-25-00821)
  • [L3] 96% of individuals with a closed displaced fracture of the olecranon treated by open reduction and internal fixation had excellent or good outcomes up to 25 years after the fracture. [2] (10.1067/mse.2002.124548)
  • [L4] Some isolated displaced (>2 mm) olecranon fractures in elderly patients can be successfully treated nonoperatively. [3] (10.1016/j.ocl.2016.08.011)
  • [L4] A majority of olecranon fractures heal uneventfully with good/excellent results with a small loss of motion to be expected. [4] (10.1016/j.hcl.2015.07.003)
  • [L3] Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures. [5] (10.1016/j.otsr.2019.08.019)
  • [L3] The incidence of olecranon fractures increased by 29% over the 20-year study period. [6] (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. [7] (10.2106/jbjs.l.01137)
  • [L3] Future studies should focus on the long-term outcomes of this technique, as compared to traditional and more established techniques to treat olecranon fractures. [8] (10.1016/j.jseint.2026.101734)
  • [L4] [9] (10.1007/s00068-021-01765-2)
  • [L5] Fixation must be secure enough to permit early motion to avoid significant stiffness of the elbow joint. [10] (10.5435/00124635-200007000-00007)
  • [L3] Both operative procedures effectively treat Mayo type II olecranon fractures. [11] (10.1186/s12891-025-08843-1)
  • [L3] Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures. [12] (10.1177/17585732221124301)
  • [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. [15] (10.1186/s12891-023-07162-7)
  • [L4] Fracture of the olecranon in a child is often only part of a complex injury to the bone and soft tissues around the elbow. [16] (10.1016/0020-1383(80)90009-1)
  • [Paper] No one technique is suitable for the management of all olecranon fractures. [18] (10.1016/j.injury.2008.12.013)
  • [L3] Plating of the olecranon leads to predictable union, though the most common complication was lack of full extension in 39% of patients. [19] (10.1016/j.injury.2016.04.015)
  • [L4] Olecranon fractures in children are usually undisplaced and incomplete, with the 'longitudinal split' fracture being not uncommon. [20] (10.1016/0020-1383(75)90056-x)
  • [L3] The timing of fixation of displaced olecranon fractures does not significantly increase the rate of early complications or reoperation. [24] (10.1016/j.jhsg.2023.09.002)
  • [L3] Olecranon fractures in the elderly have higher than expected 1 year mortality rates. [25] (10.1177/1758573221994860)
  • [L4] The literature on the treatment of olecranon fractures in elderly patients is limited. [26] (10.1007/s11678-018-0488-7)
  • [L4] [27] (10.1016/j.jse.2026.02.024)
  • [L4] [28] (10.1016/j.jhsa.2012.12.036)
  • [L4] TBW remains an effective treatment for appropriately selected olecranon fractures and in this cohort outperformed plate osteosynthesis. [34] (10.1007/s00590-015-1724-0)
  • [L4] This proposed classification system is anatomically based and considers the deforming forces from ligaments and tendons. [36] (10.1016/j.jse.2023.12.021)
  • [L5] The Mayo classification was designed to simplify categorization of olecranon fractures but does not achieve this goal due to poor reproducibility. [38] (10.1097/corr.0000000000000614)
  • [L1] Plate has better efficacy and safety for Mayo II olecranon fractures. [42] (10.1186/s13018-022-03262-7)
  • [L2] The study showed that OMC could be an effective alternative to treat olecranon fractures. [47] (10.1007/s00264-013-1878-5)
  • [L1] This supports nonoperative treatment as a reasonable option for displaced stable olecranon fractures in elderly patients. [49] (10.2106/jbjs.24.00655)
  • [L4] Articular impaction is a common feature of geriatric olecranon fractures. [50] (10.5435/jaaos-d-20-01293)
  • [L1] Internal fixation by CPS is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications and better function than TBW. [51] (10.1177/147323001204000324)
  • [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. [53] (10.1177/1558944720944261)
  • [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)
  • [L3] Low-profile double-plate osteosynthesis for treating olecranon fractures resulted in good clinical outcomes. [58] (10.1016/j.jse.2020.01.091)
  • [L4] [60] (10.1016/j.jor.2019.09.017)
  • [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. [63] (10.1016/j.xrrt.2025.08.004)
  • [L3] [66] (10.1016/j.injury.2011.10.017)

References

[1] Further Displacement After Initial Nonsurgical Treatment of Minimally Displaced Olecranon Fractures in Children. Journal of the American Academy of Orthopaedic Surgeons. 2026. DOI: 10.5435/jaaos-d-25-00821

[2] Comparison of tension-band and figure-of-eight wiring techniques for treatment of olecranon fractures. Journal of Shoulder and Elbow Surgery. 2002. DOI: 10.1067/mse.2002.124548

[3] Controversies in Fractures of the Proximal Ulna. Orthopedic Clinics of North America. 2017. DOI: 10.1016/j.ocl.2016.08.011

[4] Olecranon Fractures. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.07.003

[5] Clinical evaluation of double-plate osteosynthesis for olecranon fractures: A retrospective case-control study. Orthopaedics & Traumatology: Surgery & Research. 2019. DOI: 10.1016/j.otsr.2019.08.019

[6] Epidemiology and Treatment of Olecranon Fractures: a nationwide register-based analysis of 27,880 cases in Denmark from 1999 to 2018. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05970-2

[7] Nonoperative Management of Displaced Olecranon Fractures in Low-Demand Elderly Patients. Journal of Bone and Joint Surgery. 2014. DOI: 10.2106/jbjs.l.01137

[8] Suture tension band fixation reduces hardware complications in olecranon fractures: a comparative study. JSES International. 2026. DOI: 10.1016/j.jseint.2026.101734

[9] 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

[10] Olecranon Fractures: Treatment Options. Journal of the American Academy of Orthopaedic Surgeons. 2000. DOI: 10.5435/00124635-200007000-00007

[11] 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

[12] Mortality and subsequent fractures of patients with olecranon fractures compared to other upper extremity osteoporotic fractures. Shoulder & Elbow. 2022. DOI: 10.1177/17585732221124301

[15] 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

[16] Fractures of the olecranon in children. Injury. 1980. DOI: 10.1016/0020-1383(80)90009-1

[18] Olecranon fractures. Injury. 2009. DOI: 10.1016/j.injury.2008.12.013

[19] Outcomes after plating of olecranon fractures: A multicenter evaluation. Injury. 2016. DOI: 10.1016/j.injury.2016.04.015

[20] Olecranon fractures in children. Injury. 1975. DOI: 10.1016/0020-1383(75)90056-x

[21] Aaos Comprehensive Orthopaedic Review 3. Fractures of the Elbow > II. Olecranon Fractures.

[22] Rockwood And Green S Fractures In Adults. 40: Fractures of the Proximal Forearm: Olecranon, Proximal Radius, and Radial Head > Assessment of Olecranon Fractures.

[24] 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

[25] 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

[26] Nonoperative treatment of olecranon fractures in the elderly—a systematic review. Obere Extremität. 2018. DOI: 10.1007/s11678-018-0488-7

[27] 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

[28] Olecranon Fractures. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2012.12.036

[29] Tachdjian S Pediatric Orthopaedics From The Texas Scottish Rite Hospital For Children E Book. Pigmented Villonodular Synovitis and Giant Cell Tumor of the Tendon Sheath > Olecranon Fractures.

[32] A Lange Medical Book Current Diagnosis Treatment In Orthopedics Fifth Edition. 2Musculoskeletal Trauma Surgery > OLECRANON FRACTURES (ICD-9:813.01).

[34] Outcome after olecranon fracture repair: Does construct type matter?. European Journal of Orthopaedic Surgery & Traumatology. 2015. DOI: 10.1007/s00590-015-1724-0

[36] A novel fragment specific classification of complex olecranon fractures: 3-dimensional model design, radiological validation, and proposed surgical algorithm. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2023.12.021

[38] Classifications in Brief: Mayo Classification of Olecranon Fractures. Clinical Orthopaedics & Related Research. 2018. DOI: 10.1097/corr.0000000000000614

[42] 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

[47] 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

[49] Surgery for Olecranon Fractures in the Elderly (SOFIE). Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.24.00655

[50] 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

[51] Randomized Prospective Study of Olecranon Fracture Fixation: Cable Pin System versus Tension Band Wiring. Journal of International Medical Research. 2040. DOI: 10.1177/147323001204000324

[53] Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review. HAND. 2020. DOI: 10.1177/1558944720944261

[57] Quantitative 3-dimensional computed tomography analysis of olecranon fractures. Journal of Shoulder and Elbow Surgery. 2016. DOI: 10.1016/j.jse.2015.10.002

[58] Can low-profile double-plate osteosynthesis for olecranon fractures reduce implant removal? A retrospective multicenter study. Journal of Shoulder and Elbow Surgery. 2020. DOI: 10.1016/j.jse.2020.01.091

[60] Plate fixation and tension band wiring after isolated olecranon fracture comparison of outcome and complications. Journal of Orthopaedics. 2020. DOI: 10.1016/j.jor.2019.09.017

[63] Risk factors for complications and poor function after open reduction and fixation of olecranon fractures. JSES Reviews, Reports, and Techniques. 2025. DOI: 10.1016/j.xrrt.2025.08.004

[66] The epidemiology of fractures of the proximal ulna. Injury. 2012. DOI: 10.1016/j.injury.2011.10.017

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2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

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.


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