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Closed reduction and long arm casting
0%
6/2757
Early motion with a hinged elbow brace
7/2757
Open reduction internal fixation with a tension band construct
15%
411/2757
Open reduction internal fixation with a plate
84%
2303/2757
Fragment excision and advancement of the triceps tendon
1%
20/2757
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The radiograph shows an olecranon fracture with articular comminution and depression of a large intra-articular fragment. This pattern is best treated with plate fixation to support the articular reduction. Bailey et al reviewed 25 cases of olecranon fractures (simple and comminuted fracture patterns) treated with plate fixation. All 25 went on to union. There were no major complications reported. Twenty percent of patients underwent hardware removal at a later date for prominence. Hak et al review the treatment options available for olecranon fractures. Simple intra-articular fractures without comminution are suitable for tension band fixation. Comminution of the articular surface is an indication for plate fixation and may benefit from bone graft to support depressed articular segments. Osteoporotic patients or fractures with severe comminution may do better with fragment excision and advancement of the triceps.
4.2
(26)
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