Makindo Medical Notes

🦴 Introduction

• Olecranon fractures involve the proximal ulna at the “pointy” tip of the elbow.
• They often result from a direct blow or fall on an outstretched hand (FOOSH).
• They are intra-articular and can significantly impair extension if not managed properly.

🩺 Clinical Features

• Visible swelling and deformity over posterior elbow.
• Palpable bony gap at the olecranon process.
• Loss of triceps function: inability to extend the elbow.
• Check and document neurological status (median, radial, ulnar nerves).
• Check and document vascular status (radial & ulnar pulses).

🩻 X-Ray Findings

• AP & Lateral Views: Displacement best seen on lateral film.
• Look for associated radial head or distal humerus fractures.
• Effusion or fat pad sign may indicate occult fracture.

⚡ Management

• Pain relief: IV paracetamol ± opioids.
• Immobilisation: Long-arm backslab at 90° with broad-arm sling.
• Refer to orthopaedics: Most displaced fractures need fixation.

🔧 Surgical Options

• Tension Band Wiring (TBW): Standard for simple displaced fractures.
• Plate Fixation: Used for comminuted or unstable fractures.
• Non-operative: Only for undisplaced or frail, low-demand patients.

⚠️ Key Considerations

• Complications: stiffness, loss of extension, non-union, post-traumatic arthritis.
• Document neurovascular status before and after any intervention.
• Early physio is crucial post-fixation to restore motion.

📊 Comparison of Common Elbow Injuries