While you’re in the emergency room, your doctor will apply a splint (like a cast) to your elbow and give you a sling to keep the elbow in place. Immediate treatment may also include:
- Applying ice to reduce pain and swelling
- Medicines to relieve pain
Your doctor will determine if your fracture requires surgery. Many olecranon fractures will require surgery.
Non-surgical treatment
If the pieces of bone are not out of place (displaced), a fracture can sometimes be treated with a splint to hold the elbow in place during healing. During the healing process, your doctor will take frequent X-rays to make sure the bone is not displaced.
You will typically wear a splint for 6 weeks before starting gentle movements. If the fracture changes position during this time, you may need surgery to put the bones back together.
Surgical treatment
Surgery is usually required for olecranon fractures where:
- The bones have moved out of place (displaced fracture)
- Pieces of bone have punctured the skin (open fracture)
Surgery for olecranon fractures typically involves setting the broken pieces of bone back in place and preventing them from moving out of place until they heal.
Because of the increased risk of infection, open fractures are scheduled for surgery as soon as possible, usually within hours of diagnosis. Patients are given antibiotics through a vein (intravenously) in the emergency room and may be given a tetanus shot. During the operation, the wounds from the injury and the surfaces of the broken bone are thoroughly cleaned. The bone will typically be repaired during the same operation.
Surgical procedures
Open reduction and internal fixation. This is the procedure most commonly used to treat olecranon fractures. During the procedure, the bone fragments are first repositioned (reduced) to their normal alignment. The pieces of bone are then held in place with screws, wires, pins, or metal plates attached to the outside of the bone.
Some common methods of internal fixation are shown below.
Bone transplantation. If some of the bone has been lost through the wound or is crushed, the fracture may require bone grafting to fill the gaps. Bone graft can be taken from a donor (allograft) or from another bone in your own body (autograft). In some cases, an artificial material can be used instead of bone grafting.
Complications of surgery
There are risks associated with any surgery. If your doctor recommends surgery, they believe the potential benefits outweigh the risks.
Potential complications include:
Elbow stiffness. One of the most common problems patients face after any fracture around the elbow is stiffness. It is very important to begin physical therapy as directed to avoid elbow stiffness. In most cases
Infection. There is a risk of infection with any operation. Your doctor will take specific precautions to prevent infection.
Hardware irritation. A small percentage of patients may experience irritation from the metal implants used to repair the fracture.
Damage to nerves and blood vessels. There is a smaller risk of damage to the nerves and blood vessels around the elbow. This is an unusual side effect.
Non-association. Sometimes a break doesn’t heal. The fracture can pull apart and screws, plates or wires can move or break. This can occur for a number of reasons, including:
- The patient does not follow the instructions after the operation.
- The patient has a health problem, such as diabetes, that delays healing. Smoking or using other tobacco products also delays healing. Get more information: Smoking and surgery
- If the break was associated with a cut in the skin (open fracture), healing is often slower.
- Infections can also slow or prevent healing.
If the fracture does not heal, you may need further surgery.
