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15 Cards in this Set
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- Back
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What structure delineates the distal border of the greater sigmoid (semilunar) notch of the ulna?
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The coronoid process
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A fracture of the olecranon with displacement represents a functional disruption of the mechanism of what muscle group?
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Triceps (so a loss of active extension of the elbow would be seen)
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What type of injury pattern leading to fracture of the olecranon is more common, direct or indirect?
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Indirect is more common: A sudden eccentric contraction of the triceps upon a flexed elbow typically results in a transverse or oblique fracture
A direct injury is due to a fall on the point of the elbow or direct trauma to the olecranon which typically results in a comminuted olecranon fracture |
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Why should a careful neurosensory evaluation be performed with fracture of the olecranon?
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Associated ulnar nerve injury is possible, especially with comminuted fractures resulting from high energy injuries
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What classification system is used for olecranon fractures?
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The Mayo Classification
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Describe the Mayo classification system for fractures of the olecranon
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The Mayo classification divides fractures according to displacement, comminution, and subluxation
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What is the treatment for Type 1 olecranon fractures?
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Nonoperative
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What is the treatment for Type 2 olecranon fractures?
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These have displacement of the proximal fragment without elbow instability; these fractures require operative treatment
Type IIA (noncomminuted): Tx with tension band wire fixation Type IIB (comminuted): May require plate fixation |
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What is the treatment for Type 3 olecranon fractures?
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These have instability of the ulnohumeral joint and require surgical tx
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What classification for olecranon fractures is based upon the fracture pattern?
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Schatzker (note, Scatzker also classifies tibial plateau fractures)
Note: This is not mentioned in Rockwood and Green's, but it is mentioned in Fractures. It is essentially just a descriptive classification (transverse, transverse-impacted, oblique, comminuted, oblique-distal, fracture-dislocation) |
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What is the nonoperative treatment for olecranon fractures?
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Immobilization in a long arm cast or splint with the elbow in 45 to 90 degrees of flexion is favored by many, but in a reliable patient, a posterior splint with gradual ROM after 5-7 days may be used
Follow up X-Ray after 5-7 days to be sure displacement hasn't occurred |
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What type of operative treatment is indicated for avulsion-type olecranon fractures?
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Tension band wiring in combination with two parallel Kirschner wires.
The K wires are bent 180 degrees and are impacted into the olecranon beneath the triceps insertion |
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What type of operative treatment is indicated for comminuted olecranon fractures, Monteggia fractures, and olecranon fracture-dislocation, and fractures that extend distal to the coronoid?
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Plate and screws
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How would the following types of olecranon fractures be treated?:
Nonunited fractures, extensively comminuted fractures, fractures in elderly individuals with severe osteopenia and low functional requirements, and extra-articular fractures |
Excision with repair of the triceps tendon
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What is the most common complication of operative repair of an olecranon fracture?
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Symptomatic hardware may occur in up to 80% of patients. 34-66% may require hardware removal
A more serious complication is decreased range of elbow motion. This may complicate up to 50% of cases, particularly loss of elbow extension, although most patients note little if any functional limitation |
