An olecranon fracture is a common elbow fracture. It is a break in the ulna bone at the point of the elbow.
An olecranon fracture may occur if people have a direct fall or blow to the elbow. People may feel intense pain and be unable to move their elbow. Treatment may include wearing a splint, physical therapy, or surgery.
This article looks at the symptoms, causes, treatment, and recovery of an olecranon fracture.
An olecranon fracture is a break in a part of the ulna bone of the elbow. The elbow joint consists of three arm bones:
- the humerus
- the radius
- the ulna
An olecranon fracture is common and often occurs with no other injury to the elbow. An olecranon fracture may be complex if the bone breaks into multiple pieces and moves far out of alignment. This is a displaced fracture.
An open fracture occurs if the bone breaks through the thin tissue of the elbow, which can increase the risk of infection. Open fractures account for around
An olecranon fracture may occur through direct force or injury to the elbow, such as falling on the elbow.
If people break a fall with an outstretched arm, they may lock the elbow tight to brace themselves. This may cause the triceps muscle attached to the olecranon to pull a section of bone away from the ulna. The injury may also affect ligaments surrounding the elbow.
Symptoms of an olecranon fracture may include:
- sudden, intense pain
- being unable to move the elbow
- swelling around the point of the elbow
- bruising on the elbow and possibly on the lower or upper arm
- tenderness of the elbow when touched
- numbness in one or more fingers
- pain when moving the elbow or rotating the forearm
- a feeling of instability in the elbow joint
Direct force and injury to the elbow may lead to an olecranon fracture. Common causes of an olecranon fracture include:
- falling directly onto the elbow
- falling on an outstretched arm with the elbow locked tightly to protect against the fall
- a direct hit to the elbow from a hard object, such as a baseball bat or part of a vehicle during a collision
The average age of people with an olecranon fracture is
To diagnose an olecranon fracture, a doctor may assess symptoms and perform a physical examination. This may include:
- checking the skin of the elbow for any cuts, bruising, or swelling
- feeling the elbow for tenderness and checking for other injuries
- checking the pulse at the wrist to see whether an injury has affected blood flow to the hands
- checking movement and sensation in the wrist and fingers
- checking the shoulder, arm, wrist, and hand for other injuries
An X-ray can show whether there is an olecranon fracture and how the bone has broken. A doctor may also X-ray other areas of the arm, shoulder, wrist, or hands to check for other fractures.
Depending on the type of olecranon fracture, people may need nonsurgical or surgical treatment.
Immediate treatment may include:
- splinting the elbow and putting it in a sling to prevent movement
- applying ice to reduce swelling and relieve pain
- taking pain-relief medications
Below are some nonsurgical and surgical treatment options.
Nonsurgical treatment
Nonsurgical treatment may be suitable if the broken bones remain in alignment.
People may have a splint or a sling to keep the elbow fixed while it heals. During this time, people will need regular X-rays to allow a doctor to monitor progress and ensure the bone is kept in place until it fuses together.
Surgical treatment
According to the American Academy of Orthopedic Surgeons, most olecranon fractures require surgical treatment if they are displaced or open.
If a person has an open fracture, they will usually need surgery within hours of receiving a diagnosis. Before surgery, they may receive intravenous antibiotics and a tetanus shot to reduce the risk of infection.
Surgery to repair a displaced or open fracture may involve:
- making an incision into the back of the elbow to access the bones
- moving the broken sections of bone back into their normal positions
- securing the bone in place using screws, pins, or metal plates until it heals
If there is damage to some sections of the bone or part of the bone has been lost through an open wound, people may need a bone graft.
A bone graft uses bone from another area of the body, a donor, or an artificial material that replicates bone to replace missing pieces of bone.
If people require a splint to repair an olecranon fracture, the elbow may feel very stiff after the cast comes off, and they may need physical therapy to regain their typical range of motion.
People may need to avoid heavy lifting or bearing weight for around 6 weeks.
If a person does not have a displaced fracture, meaning the pieces of broken bone remain in alignment, they may be able to begin physical therapy to gently move the elbow after 6 weeks of wearing a splint.
People may find that over-the-counter pain relief medications, ice, and elevation help reduce pain during recovery.
After surgery, people can begin gently moving the elbow straight away, working alongside a physical or occupational therapist.
Possible complications of an olecranon fracture may depend on the type of fracture people have and whether they require surgery. Complications may include:
- infection from an open fracture or surgery
- elbow stiffness, which physical therapy may help prevent
- hardware irritation, where metal implants that hold the bone together cause irritation
- damage to nerves and blood vessels, which may happen during surgery, although this is not common
- nonunion, where the bones do not rejoin together, although this may only occur in
1% of cases - loss of motion, where people cannot fully straighten their arm, although this is rare
- post-traumatic arthritis, which may affect a joint after injury due to cartilage damage
People may be able to resume their normal activities around 4 months after an olecranon fracture, although full recovery may take over a year.
Even when the fracture has healed, people may not experience the full range of movement they had before. Over time, this usually keeps improving.
Following treatment for an olecranon fracture, the healing rate is high, and good elbow function usually returns.
The long-term outlook is usually positive, with
An olecranon fracture is a break in a part of the ulna bone, which makes up the point of the elbow. An olecranon fracture may happen if a person falls on their elbow or has a direct hit to the elbow.
Depending on the fracture type, people may require a splint to hold the bone in place while it mends or surgery to repair the broken bone. Physical therapy after treatment may help improve the elbow’s range of motion.