The olecranon and the proc. coronoideus form
the Incisura trochlearis , which articulates with
the trochlea of the distal humerus.
The intrinsic anatomy of this articulation allows
for flexion/extension movement of the elbow
joint and provides for stability of the elbow.
high energy injuries in young
secondary to falls in the elderly
Very rare in children. The same trauma will
cause distal humeral fracture instead.
A fall on an outstretched hand with the elbow in
Sudden and violent triceps muscle contraction
can produce an avulsion fracture of varying size
of the olecranon tip
Plain radiographs are usually sufficient for isolated
fractures of the olecranon.
CT : may be useful for preoperative planning in
Type A: extraarticular
Type B: Intraarticular
Type C: Intra-articular fractures of both the radial
head and olecranon
Preservation of the extensor mechanism
Avoidance of stiffness and maintain the range of
Nondisplaced fractures (< 2mm dislocation) can be
effectively treated by immobilization of the limb in
a long-arm splint or cast with the elbow flexed at
45-90° for 4 weeks.
Displaced fracture is low demand, elderly
Contraindications include active infection and
severe medical comorbidities.
Tension band wiring technique over two
Contoured plate application to the posterior
aspect of the proximal ulna