Presentation
Fall onto right elbow.
Patient Data
A displaced fracture through the olecranon with intra-articular involvement and associated hemarthrosis.
Comminuted intra-articular fracture of the olecranon with posterior displacement of 4 mm.
A moderate joint effusion is also present.
No further fracture is identified.
Rt elbow XR 4 wk post conservative management.
The undisplaced olecranon fracture shows interval healing, fracture line still evident. Joint alignment is preserved. There is a small elbow joint effusion.
Case Discussion
Classically, displaced (> 2 mm) olecranon fractures require surgical management, especially in active young patients.1 The case above demonstrates an exception to the rule. Surgery was initially planned but instead an active decision was made for conservative management due to patient preference.
The patient was managed with cast immobilization and at 4 weeks imaging (shown above) demonstrated interval healing and satisfactory alignment. The cast was removed at this time and the patient began regular physiotherapy without any evidence of significant deficit.