Athletes may develop an olecranon stress fracture as seen in Figure A. Initially, this is treated with rest from activity. If it does not go onto union, ORIF with a compression screw is indicated. This injury is commonly seen in baseball pitchers as well as other higher-level athletes and is thought of as an overuse-type injury. This is part of the valgus-extension overload syndrome. Before it displaces, most of them are treated with a single large screw. Once it is displaced, it can be treated as any olecranon fx is treated (screw +/- tension band, or plate fixation).
The referenced study by Rettig et al is a case series of five pitchers who underwent ORIF with a 7.0mm screw for this pathology. All went onto successful union at a mean of 15.4 weeks with return to throwing at a mean of 29.4 weeks.
Illustration A depicts a compression screw and tension band construct with healed olecranon stress fracture.
Rettig AC, Wurth TR, Mieling P. Nonunion of olecranon stress fractures in adolescent baseball pitchers: a case series of 5 athletes. Am J Sports Med. 2006 Apr;34(4):653-6.
PMID:16556755 (Link to Abstract)
Garrick JG (ed): Orthopaedic Knowledge Update: Sports Medicine 3. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2004, pp 101-111