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Gãy khuỷu tay

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

Updated Aug 2026
Một minh họa vẽ tay của một người không có khuôn mặt đang ngã và tiếp đất trực tiếp lên khuỷu tay đang gập của họ.
X-quang cho thấy gãy mỏm khuỷu — phần xương nhô ra ở đầu khuỷu tay. Kieran Hirpara 4.0

Trang này được dịch bằng máy và chưa được bác sĩ kiểm tra. Bản tiếng Anh là bản chính thức.

Những gì bạn đang cảm thấy

Bạn có thể sẽ cảm thấy đau nhói ở đầu khuỷu tay. Đây là vị trí của xương mỏ khuỷu. Cơn đau thường trở nên nghiêm trọng hơn khi bạn cố gắng duỗi thẳng cánh tay chống lại lực cản. Bạn cũng có thể cảm thấy một cơn đau âm ỉ sâu, bùng phát sau khi bạn sử dụng cánh tay cho các hoạt động hàng ngày.

Các cử động đơn giản có thể trở nên khó khăn. Việc với tay ra sau lưng để cài áo ngực có thể gây đau. Việc nhét áo vào quần hoặc nâng một vật nhẹ có thể kích hoạt cơn đau tăng đột biến. Bạn có thể thấy khó khăn khi đặt cánh tay lên bàn vì áp lực lên đầu xương gây đau.

Ngủ có thể trở nên khó khăn. Nhiều bệnh nhân nhận thấy họ không thể nằm nghiêng về phía bên bị ảnh hưởng. Trọng lượng cơ thể bạn đè trực tiếp lên khuỷu tay bị thương, gây ra cơn đau đáng kể. Bạn có thể thức dậy với một khớp khuỷu tay cứng đờ, đau nhức và cảm thấy căng cứng vào buổi sáng.

Một số sưng và bầm tím là phổ biến trong những ngày sau khi bị thương. Khu vực này có thể cảm thấy ấm khi chạm vào. Nếu bạn có một vết gãy xương cũ, bạn có thể nhận thấy rằng cơn đau thay đổi theo thời tiết hoặc sau những khoảng thời gian dài bất hoạt.

Điều quan trọng là hãy lắng nghe cơ thể của bạn. Nghỉ ngơi cánh tay ở một tư thế thoải mái, thường hơi cong, có thể giúp giảm căng thẳng cho cơ tam đầu. Tránh nâng vật nặng hoặc các cử động đẩy có thể ngăn ngừa kích thích thêm cho khớp.

Mặc dù các triệu chứng này là điển hình, chúng có thể khác nhau ở mỗi người. Một số người trải nghiệm tình trạng cứng khớp nhiều hơn là đau, trong khi những người khác cảm thấy đau nhói, nhạy cảm tại một vị trí cụ thể. Nếu cơn đau của bạn trở nên nghiêm trọng hoặc bạn nhận thấy tình trạng sưng tăng lên, hãy liên hệ với bác sĩ phẫu thuật của bạn. Họ có thể giúp xác định xem các triệu chứng của bạn có phù hợp với một vết gãy xương đơn giản hay không, hoặc nếu có các yếu tố khác đang diễn ra, chẳng hạn như viêm xương khớp do hao mòn phát triển trong khớp theo thời gian.

Những gì thực sự đang xảy ra

Khuỷu tay của bạn là một khớp bản lề nơi xương cánh tay trên gặp xương cẳng tay. Mỏm khuỷu (olecranon) là phần xương nhô ra ở đầu khuỷu tay mà bạn có thể cảm thấy khi gập cánh tay. Nó hoạt động như một cái móc, bám vào xương cánh tay trên để giữ cho khớp được ổn định. Một vết gãy ở đây có nghĩa là điểm neo quan trọng này đã bị gãy.

Khi xương gãy, gân ba đầu (triceps) mạnh mẽ gắn liền với nó có thể kéo mảnh xương rời ra. Điều này làm gián đoạn bề mặt trơn tru của khớp. Không có bề mặt trơn tru, khuỷu tay của bạn không thể trượt một cách bình thường. Bạn có thể mất khả năng duỗi thẳng cánh tay hoàn toàn chống lại trọng lực. Điều này xảy ra vì hệ thống đòn bẩy cơ học không còn được căn chỉnh đúng cách.

Khớp cũng được bao quanh bởi một lớp vỏ bảo vệ gọi là bao khớp. Nếu vết gãy bị lệch, lớp vỏ này có thể bị rách hoặc giãn ra. Điều này dẫn đến sưng và đau. Trong một số trường hợp, vết gãy phức tạp, liên quan đến nhiều mảnh hoặc sự mất ổn định của các dây chằng xung quanh. Điều này khiến khớp cảm thấy lỏng lẻo hoặc không ổn định.

Bác sĩ phẫu thuật của bạn nhằm mục đích khôi phục bề mặt khớp trơn tru và khít nhau. Điều này cho phép cánh tay của bạn hoạt động bình thường trở lại. Đối với những bệnh nhân lớn tuổi có nhu cầu vận động thấp, điều trị không phẫu thuật có thể là đủ. Cơ thể đôi khi có thể tự lành vết gãy đủ tốt để mang lại chức năng thỏa đáng, ngay cả khi xương không liền hoàn hảo. Tuy nhiên, đối với nhiều người, cần cố định chắc chắn để cho phép vận động sớm. Điều này ngăn ngừa khớp bị cứng.

Nếu cần phẫu thuật, mục tiêu là giữ các mảnh xương tại chỗ để chúng lành lại. Các kỹ thuật khác nhau từ việc sử dụng dây và vít đến chỉ khâu hoặc loại bỏ hoàn toàn phần đầu gãy. Sự lựa chọn phụ thuộc vào kiểu gãy và tình trạng sức khỏe tổng thể của bạn. Trong khi hầu hết bệnh nhân đều phục hồi tốt chức năng, vẫn có nguy cơ mắc viêm xương khớp do hao mòn về lâu dài. Tỷ lệ mắc bệnh viêm xương khớp sau chấn thương trung bình sau các vết gãy mỏm khuỷu đơn độc là 19% tại thời điểm theo dõi trung bình là 41 tháng. Điều này có nghĩa là khớp có thể đau hoặc cứng dần theo thời gian, nhưng nhiều người vẫn năng động và hài lòng với quá trình phục hồi của họ.

Những gì chúng tôi có thể làm về vấn đề này

Cách tiếp cận của Bác sĩ Kieran Hirpara, một bác sĩ phẫu thuật chi trên tại Bệnh viện Tư nhân Mater Rockhampton, trong phòng khám của chúng tôi phản ánh một quyết định chung dựa trên chấn thương cụ thể và hồ sơ sức khỏe của bạn. Bệnh nhân đến phòng khám của chúng tôi thông qua giới thiệu của bác sĩ đa khoa hoặc nhà vật lý trị liệu. Đánh giá tại phòng khám giúp xác định chẩn đoán. Đối với các trường hợp gãy xương cấp tính, chúng tôi thường khuyến nghị phẫu thuật ngay lập tức. Đối với các trường hợp khác, chúng tôi thường thử điều trị không phẫu thuật trước.

Bạn có thể kiểm soát các triệu chứng nhẹ bằng cách nghỉ ngơi và chườm đá. Vật lý trị liệu nhằm khôi phục khả năng vận động và sức mạnh mà không gây đau. Chúng tôi thường khuyên nên áp dụng phương pháp này trong vài tuần để thấy kết quả. Nếu bạn lớn tuổi hoặc có các bệnh lý khác, quản lý không phẫu thuật có thể là lựa chọn tốt nhất. Bằng chứng cho thấy nhiều bệnh nhân lớn tuổi đạt được phạm vi vận động thỏa đáng và mức độ hài lòng cao mà không cần phẫu thuật. Ngay cả khi xương không liền hoàn toàn, nhiều bệnh nhân báo cáo chức năng khuỷu tay ở mức hợp lý và ít đau.

Bác sĩ phẫu thuật của bạn sẽ kê đơn thuốc giảm đau để giúp bạn đối phó. Thuốc chống viêm giúp giảm sưng. Tiêm không được sử dụng thường quy cho các gãy xương cấp tính nhưng có thể được xem xét cho viêm xương khớp do mòn lâu dài. Tiêm cortisone giúp giảm viêm trong vài tuần. Tiêm axit hyaluronic giúp bôi trơn khớp trong vài tháng. Tiêm huyết tương giàu tiểu cầu nhằm hỗ trợ quá trình lành thương, mặc dù hiệu quả có thể khác nhau. Chúng tôi chỉ thảo luận về các lựa chọn này nếu chúng phù hợp với mục tiêu dài hạn của bạn.

Phẫu thuật được xem xét khi điều trị bảo tồn không mang lại đủ cải thiện hoặc khi gãy xương bị lệch vị trí. Phẫu thuật sửa chữa xương gãy hoặc loại bỏ mảnh xương nhỏ để khôi phục chức năng cơ tam đầu. Điều này cho phép bạn cử động khuỷu tay trở lại. Hầu hết bệnh nhân giữ lại các thiết bị cấy ghép, chỉ có 3% gặp phải tình trạng di chuyển thiết bị cấy ghép. Chúng tôi hướng dẫn bạn trong quá trình ra quyết định này, đảm bảo bạn hiểu rõ lợi ích và rủi ro cho tình huống cụ thể của mình.

Những điều cần biết

Tiên lượng của bạn phụ thuộc phần lớn vào độ tuổi và mức độ hoạt động hàng ngày. Ở người cao tuổi có nhu cầu vận động thấp, việc điều trị không phẫu thuật thường mang lại kết quả ngắn hạn và dài hạn thỏa đáng. Nhiều bệnh nhân trong nhóm này đạt mức độ hài lòng cao và có tầm vận động chức năng mà không cần phẫu thuật. Ngay cả khi xương gãy không liền hoàn toàn (liền xương kém), chức năng khuỷu tay thường vẫn ở mức chấp nhận được, và đa số không yêu cầu phẫu thuật thêm.

Nếu bạn trẻ hơn hoặc năng động hơn, cố định phẫu thuật thường được khuyến nghị để khôi phục sức mạnh. Hầu hết bệnh nhân vẫn giữ lại các thiết bị cấy ghép sau thủ thuật này, chỉ có 3% gặp phải tình trạng di chuyển thiết bị cấy ghép. Thời điểm phẫu thuật không làm tăng đáng kể biến chứng sớm hoặc nhu cầu phẫu thuật lại. Dù được điều trị bằng dây thép, tấm kim loại hoặc neo, kết quả chức năng nhìn chung đều tốt. Ở những bệnh nhân năng động, không có sự khác biệt về kết quả do bệnh nhân báo cáo sau 1 năm giữa các phương pháp phẫu thuật phổ biến như cố định bằng dây thép vòng căng và cố định bằng tấm kim loại.

Bạn nên nhận thức được những thay đổi tiềm ẩn về lâu dài. Tỷ lệ mắc trung bình của viêm xương khớp sau chấn thương sau khi gãy mỏm khuỷu đơn độc là 19% tại thời điểm theo dõi trung bình là 41 tháng. Viêm xương khớp do hao mòn này có thể gây cứng khớp hoặc đau đớn theo thời gian. Tuy nhiên, kết quả chức năng dài hạn tốt vẫn được kỳ vọng trong các trường hợp phức tạp, ngay cả khi có những thay đổi do viêm xương khớp.

Ở bệnh nhân cao tuổi, chấn thương này đi kèm với tỷ lệ tử vong sau 1 năm cao hơn dự kiến so với các loại gãy xương khác. Điều này phản ánh tình trạng sức khỏe tổng thể của nhóm nhân khẩu học này hơn là bản thân vết gãy xương. Nếu bạn trên 75 tuổi, bằng chứng chưa giải quyết dứt khoát cuộc tranh luận về việc điều trị không phẫu thuật, nhưng nó cung cấp dữ liệu để xây dựng kế hoạch điều trị cá nhân hóa. Bác sĩ phẫu thuật của bạn sẽ thảo luận xem hướng đi nào phù hợp nhất với hồ sơ sức khỏe cụ thể và mục tiêu của bạn.

Khi nào cần gặp bác sĩ

Hãy gặp bác sĩ đa khoa nếu bạn có cơn đau dai dẳng không cải thiện khi nghỉ ngơi, hoặc nếu khuỷu tay của bạn cảm thấy yếu hoặc không vững. Hãy yêu cầu được bác sĩ chuyên khoa thăm khám nếu khớp bị khóa, bị mất ổn định, hoặc nếu các triệu chứng ảnh hưởng đến giấc ngủ hoặc công việc của bạn. Việc đau tăng lên đột ngột cũng là lý do để bạn đi khám. Mặc dù hầu hết các trường hợp gãy xương đều lành tốt, hãy lưu ý rằng 19% bệnh nhân có thể phát triển viêm xương khớp do hao mòn sau này. Ở người cao tuổi, những chấn thương này đi kèm với nguy cơ cao hơn về các biến chứng sức khỏe nghiêm trọng trong năm đầu tiên. Việc đánh giá sớm giúp quản lý các nguy cơ này và đảm bảo bạn nhận được sự hỗ trợ phù hợp cho quá trình hồi phục.


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 minimally displaced olecranon fractures in children to monitor for further displacement [1].
  • Nonoperative management of isolated displaced olecranon fractures yields satisfactory short-term and long-term outcomes in older, lower-demand patients [7].
  • A majority of olecranon fractures heal uneventfully with good or excellent results, with a small loss of motion to be expected [4].
  • Operative treatment of closed displaced olecranon fractures via open reduction and internal fixation results in excellent or good outcomes in 96% of individuals up to 25 years after the fracture [2].
  • Low-profile double-plate osteosynthesis is a safe and effective alternative treatment for olecranon fractures, providing excellent subjective and objective clinical outcome measures [5].
  • Both Kirschner wire tension band combined with anatomical locking plate and other operative procedures effectively treat Mayo type II olecranon fractures [8].
  • Plating of the olecranon leads to predictable union, although lack of full extension is the most common complication, occurring in 39% of patients [17].
  • Tension-band wiring (TBW) remains an effective treatment for appropriately selected olecranon fractures and outperformed plate osteosynthesis in the evaluated cohort [22].
  • Excision of the olecranon fragment with repair of the triceps mechanism is supported as the preferred treatment method due to significantly less morbidity compared with internal fixation [25].
  • The timing of fixation for displaced olecranon fractures does not significantly increase the rate of early complications or reoperations [13].
  • Surgical treatment of olecranon fractures is associated with a high rate of complications, and patients undergoing revisions beyond implant removal had poorer functional outcomes [39].
  • No significant differences in functional outcomes or secondary operations were found with respect to fracture type, gender, or surgical method in the context of olecranon fracture complications [39].
  • Olecranon osteotomy represents a useful alternative for the treatment of fractures and nonunions of the distal humerus [41].

Anatomy & Pathophysiology

  • Fixation of olecranon fractures must be secure enough to permit early motion to avoid significant stiffness of the elbow joint [10].
  • In pediatric olecranon fractures, treatment with a sling resulted in all cases being free of symptoms and having a full range of elbow movement at 3 weeks [11].
  • Increasing elbow flexion places the medial elbow in a position to carry a greater amount of load, which may be exacerbated during the final moments of the pitching motion [27].
  • Individuals with elbow degenerative changes had no inferior subjective elbow function compared to those with normal radiographs, except for those with joint space reduction [29].
  • Primary elbow instability and fracture morphology are prognostic factors for elbow function and development of arthrosis after operative treatment of olecranon fractures [35].
  • The outcome of tension-band wiring may be compromised in the presence of elbow instability and associated fractures of the radial head and coronoid [38].
  • A pathoanatomic approach using the CURL framework systematically evaluates key injury components (coronoid, ulna, radial head, and ligaments) to guide surgical planning for proximal ulna fracture dislocation [43].
  • Accurate diagnosis of complex elbow fracture-dislocations, such as posterior Monteggia fractures and posterior fracture-dislocation of the proximal ulna, helps provide effective treatments and evaluate prognosis [44].
  • The guiding principle in surgical techniques for olecranon fractures is to restore a congruent humeroulnar joint and allow restoration of upper extremity function [47].
  • Technological advances and improved understanding of functional anatomy have led to an evolution in operative reconstruction of complex proximal ulnar and coronoid fractures [48].
  • The proposed novel fragment-specific classification of complex olecranon fractures is anatomically based and considers the deforming forces from ligaments and tendons [49].
  • The Subjective Elbow Value (SEV) shows a high correlation to the most commonly used scoring systems for outcome evaluation after elbow injury [51].
  • A stable, functional elbow can be restored in most patients with proximal ulna fractures treated with open reduction and internal fixation [52].
  • Targeting the proximal ulna's narrowest segment provides an effective approach for osteotomy when precise morphology is unknown [53].
  • Radiographic measurements of normal elbows guide the surgeon to obtain a more reliable length of the olecranon and maintain articular geometry during fixation [54].

Classification

  • The Mayo classification was designed to simplify categorization of olecranon fractures but does not achieve this goal due to poor reproducibility [26].
  • Quantitative 3-dimensional computed tomography analysis further clarified the fracture morphology of Mayo type I, II, and III fractures [36].
  • Fracture of the olecranon in a child is often only part of a complex injury to the bone and soft tissues around the elbow [19].
  • The olecranon apophyseal ossification system, when combined with age and sex, successfully predicts peak height velocity within a year in 90% of cases, establishing a single lateral view of the olecranon as a simple alternative to more complex grading systems [40].

Clinical Presentation

  • Olecranon fractures in children can displace further after initial nonsurgical treatment, necessitating close radiographic follow-up [1].
  • Isolated displaced olecranon fractures (>2 mm) in elderly patients can be successfully treated nonoperatively [3].
  • The incidence of olecranon fractures increased by 29% over a 20-year study period (1999–2018) in Denmark [6].
  • Nonoperative management of isolated displaced olecranon fractures in older, lower-demand patients yields satisfactory short-term and long-term outcomes [7].
  • Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures [9].
  • All 10 pediatric cases treated with a sling were free of symptoms and had a full range of elbow movement at 3 weeks [11].
  • Olecranon fractures in the elderly have higher than expected 1-year mortality rates [14].
  • Isolated fractures of the olecranon occur after low-energy trauma, especially in older women (>65 years) [15].
  • Fractures of the olecranon in children are often part of a complex injury to the bone and soft tissues around the elbow [19].
  • Articular impaction is a common feature of geriatric olecranon fractures [20].
  • The median incidence of post-traumatic osteoarthritis following isolated olecranon fractures is 19% at a median follow-up of 41 months [21].

Investigations

  • Close radiographic follow-up is recommended for nonsurgically treated olecranon fractures [1].
  • Some isolated displaced (>2 mm) olecranon fractures in elderly patients can be successfully treated nonoperatively [3].
  • Olecranon stress fracture is an overuse injury primarily affecting throwing athletes, with MRI serving as the gold standard for detection [50].

Treatment

Nonoperative Management

  • The literature on the treatment of olecranon fractures in elderly patients is limited [18].
  • Nonoperative treatment is a reasonable option for displaced stable olecranon fractures in elderly patients [31].
  • 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 [34].
  • Aggregate data support the non-operative treatment of isolated undisplaced olecranon fractures with good results in pediatric patients [33].

Operative Management

  • A majority of olecranon fractures heal uneventfully with good/excellent results with a small loss of motion to be expected [4].
  • 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].
  • Fixation must be secure enough to permit early motion to avoid significant stiffness of the elbow joint [10].
  • No one technique is suitable for the management of all olecranon fractures [16].
  • Aggregate data support the operative treatment of pediatric olecranon fractures displaced ≥4 mm [33].
  • Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures with excellent subjective and objective clinical outcome measures [5].
  • Low-profile double-plate osteosynthesis for treating olecranon fractures resulted in good clinical outcomes [37].
  • Tension band wiring (TBW) remains an effective treatment for appropriately selected olecranon fractures and outperformed plate osteosynthesis in the studied cohort [22].
  • 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 TBW [23].
  • Plate has better efficacy and safety for Mayo II olecranon fractures [28].
  • The nickel-titanium olecranon memory connector (OMC) could be an effective alternative to treat olecranon fractures [30].
  • Excision of the fragment of the olecranon with repair of the triceps mechanism is supported as the preferred method of treatment of fractures of the olecranon due to significantly less morbidity compared with internal fixation [25].

Complications

  • Close radiographic follow-up is recommended for nonsurgically treated olecranon fractures to monitor for further displacement [1].
  • Minimally displaced olecranon fractures in children can undergo further displacement after initial nonsurgical treatment [1].
  • A majority of olecranon fractures heal uneventfully with good or excellent results, though a small loss of motion is expected [4].
  • Olecranon fractures in children treated with a sling result in full range of elbow movement and freedom from symptoms at 3 weeks [11].
  • The most common complication after plating of olecranon fractures is lack of full extension, occurring in 39% of patients [17].
  • Plating of the olecranon leads to predictable union [17].
  • The incidence of post-traumatic osteoarthritis following isolated olecranon fractures has a median rate of 19% at a median follow-up of 41 months [21].
  • Instability and comminution play a role in the development of post-traumatic osteoarthritis in olecranon fractures [21].
  • Olecranon fractures in the elderly are associated with higher than expected 1-year mortality rates [14].
  • Patients aged 50 years or more with an olecranon fracture should be evaluated for osteoporosis and fracture risks for secondary prevention [46].

Recovery

  • All 10 cases of pediatric olecranon fractures treated with a sling were free of symptoms and had a full range of elbow movement at 3 weeks [11].
  • 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) [23].
  • The timing of fixation of displaced olecranon fractures does not significantly increase the rate of early complications or reoperation [13].

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] Both operative procedures effectively treat Mayo type II olecranon fractures. [8] (10.1186/s12891-025-08843-1)
  • [L3] Patients with olecranon fractures have essentially similar demographic characteristics compared to patients with distal radius fractures. [9] (10.1177/17585732221124301)
  • [L5] Fixation must be secure enough to permit early motion to avoid significant stiffness of the elbow joint. [10] (10.5435/00124635-200007000-00007)
  • [L4] All 10 cases treated with a sling were free of symptoms and had a full range of elbow movement at 3 weeks. [11] (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. [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] Isolated fractures of the olecranon occur after a low-energy trauma, especially in older women (> 65 years). [15] (10.1007/s00068-021-01765-2)
  • [Paper] No one technique is suitable for the management of all olecranon fractures. [16] (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. [17] (10.1016/j.injury.2016.04.015)
  • [L4] The literature on the treatment of olecranon fractures in elderly patients is limited. [18] (10.1007/s11678-018-0488-7)
  • [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. [19] (10.1016/0020-1383(80)90009-1)
  • [L4] Articular impaction is a common feature of geriatric olecranon fractures. [20] (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. [21] (10.1016/j.jse.2026.02.024)
  • [L4] TBW remains an effective treatment for appropriately selected olecranon fractures and in this cohort outperformed plate osteosynthesis. [22] (10.1007/s00590-015-1724-0)
  • [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. [23] (10.1177/147323001204000324)
  • [L3] The study supports the rationale for excision of the fragment of the olecranon with repair of the triceps mechanism as the preferred method of treatment of fractures of the olecranon due to significantly less morbidity compared with internal fixation. [25] (10.2106/00004623-198163050-00005)
  • [L5] The Mayo classification was designed to simplify categorization of olecranon fractures but does not achieve this goal due to poor reproducibility. [26] (10.1097/corr.0000000000000614)
  • [L4] Increasing elbow flexion has been shown to place the medial elbow in a position to carry a greater amount of load, which may be exacerbated during the final moments of the pitching motion. [27] (10.1177/03635465211072223)
  • [L1] Plate has better efficacy and safety for Mayo II olecranon fractures. [28] (10.1186/s13018-022-03262-7)
  • [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. [29] (10.1007/s00402-020-03453-z)
  • [L2] The study showed that OMC could be an effective alternative to treat olecranon fractures. [30] (10.1007/s00264-013-1878-5)
  • [L1] This supports nonoperative treatment as a reasonable option for displaced stable olecranon fractures in elderly patients. [31] (10.2106/jbjs.24.00655)
  • [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. [33] (10.1302/2058-5241.5.190082)
  • [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. [34] (10.1177/1558944720944261)
  • [L3] Primary elbow instability and fracture morphology are prognostic factors for elbow function and development of arthrosis after operative treatment of olecranon fractures. [35] (10.1016/j.injury.2003.12.002)
  • [L4] Quantitative analysis of olecranon fractures further clarified fracture morphology of Mayo type I, II, and III fractures. [36] (10.1016/j.jse.2015.10.002)
  • [L3] Low-profile double-plate osteosynthesis for treating olecranon fractures resulted in good clinical outcomes. [37] (10.1016/j.jse.2020.01.091)
  • [L4] However, the outcome may be compromised in the presence of elbow instability and associated fractures of the radial head and coronoid. [38] (10.1016/j.jse.2005.08.002)
  • [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. [39] (10.1016/j.xrrt.2025.08.004)
  • [L3] When combined with age and sex, the olecranon system successfully predicts PHV within a year in 90% of cases, establishing a single lateral view of the olecranon as a simple alternative to more complex grading systems. [40] (10.2106/jbjs.20.01856)
  • [L4] Olecranon osteotomy represents a useful alternative in the treatment of fractures and nonunions of the distal humerus. [41] (10.1097/00005131-200408000-00010)
  • [L5] The authors propose a pathoanatomic approach using the CURL framework to systematically evaluate key injury components (coronoid, ulna, radial head, and ligaments) to guide surgical planning and improve outcomes. [43] (10.1177/17585732251348668)
  • [L4] Accurate diagnoses of these complex elbow fracture-dislocation help doctors to provide effective treatments and evaluate prognosis. [44] (10.1111/os.12784)
  • [L4] Our results suggest that patients aged 50 years or more with olecranon fracture should be evaluated for osteoporosis and fracture risks for secondary prevention of subsequent fractures. [46] (10.11005/jbm.2017.24.3.175)
  • [L5] The guiding principle is to restore a congruent humeroulnar joint and allow restoration of upper extremity function. [47] (10.1016/j.jhsa.2014.05.014)
  • [Paper] Technological advances and improved understanding of functional anatomy have led to an evolution in operative reconstruction of complex proximal ulnar and coronoid fractures. [48] (10.1016/j.injury.2016.07.060)
  • [L4] This proposed classification system is anatomically based and considers the deforming forces from ligaments and tendons. [49] (10.1016/j.jse.2023.12.021)
  • [L5] Olecranon stress fracture is an overuse injury primarily affecting throwing athletes, with MRI serving as the gold standard for detection. [50] (10.1016/j.csm.2020.02.005)
  • [L4] The SEV shows a high correlation to the most commonly used scoring systems for outcome evaluation after elbow injury. [51] (10.1055/a-0946-2649)
  • [L3] A stable, functional elbow can be restored in most patients with proximal ulna fractures treated with open reduction and internal fixation. [52] (10.1007/s00590-015-1628-z)
  • [L5] Targeting the proximal ulna's narrowest segment provides an effective approach for osteotomy when precise morphology is unknown. [53] (10.1016/j.jse.2024.12.012)
  • [L4] The authors conclude that these measurements guide the surgeon to obtain a more reliable length of the olecranon and maintain articular geometry during fixation. [54] (10.1002/ca.20431)

References

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[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] 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

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

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

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

[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] 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

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

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

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

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

[20] 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

[21] 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

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

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

[25] Operative treatment of olecranon fractures. Excision or open reduction with internal fixation.. The Journal of Bone & Joint Surgery. 1981. DOI: 10.2106/00004623-198163050-00005

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

[27] Increased Elbow and Olecranon Injury History in Professional Pitchers With Increased Elbow Flexion at Ball Release. The American Journal of Sports Medicine. 2022. DOI: 10.1177/03635465211072223

[28] 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

[29] 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

[30] 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

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

[33] Paediatric olecranon fractures: a systematic review. EFORT Open Reviews. 2020. DOI: 10.1302/2058-5241.5.190082

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

[35] Olecranon fractures in adults: factors influencing outcome. Injury. 2004. DOI: 10.1016/j.injury.2003.12.002

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

[37] 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

[38] Tension-band wiring for olecranon fractures: Analysis of risk factors for failure. Journal of Shoulder and Elbow Surgery. 2006. DOI: 10.1016/j.jse.2005.08.002

[39] 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

[40] The Relationship of Olecranon Apophyseal Ossification and Sanders Hand Scores with the Timing of Peak Height Velocity in Adolescents. Journal of Bone and Joint Surgery. 2021. DOI: 10.2106/jbjs.20.01856

[41] Olecranon Osteotomy for Exposure of Fractures and Nonunions of the Distal Humerus. Journal of Orthopaedic Trauma. 2004. DOI: 10.1097/00005131-200408000-00010

[43] Proximal ulna fracture dislocation: Review of current concepts and surgical management. Shoulder & Elbow. 2025. DOI: 10.1177/17585732251348668

[44] Difference Between Posterior Monteggia Fractures and Posterior Fracture‐Dislocation of Proximal Ulna in Adults. Orthopaedic Surgery. 2020. DOI: 10.1111/os.12784

[46] Olecranon Fractures Have Features of Osteoporotic Fracture. Journal of Bone Metabolism. 2017. DOI: 10.11005/jbm.2017.24.3.175

[47] Surgical Techniques of Olecranon Fractures. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.05.014

[48] Complex coronoid and proximal ulna fractures are we getting better at fixing these?. Injury. 2016. DOI: 10.1016/j.injury.2016.07.060

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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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