 | This article needs additional citations for verification .(December 2020) |
| Olecranon fracture | |
|---|---|
 | |
| Fracture of the olecranon | |
| Specialty | Orthopedic |
Olecranon fracture is a fracture of the bony portion of the elbow. The injury is fairly common and often occurs following a fall or direct trauma to the elbow. The olecranon is the proximal extremity of the ulna which is articulated with the humerus bone and constitutes a part of the elbow articulation. Its location makes it vulnerable to direct trauma.
People with olecranon fractures present with intense elbow pain after a direct blow or fall. [1] Swelling over the bone site is seen and an inability to straighten the elbow is common. Due to the proximity of the olecranon to the ulnar nerve, the injury and swelling may cause numbness and tingling at the fourth and fifth fingers. [1] Examination can bring out a palpable defect at the site of the fracture. [2]
Olecranon fractures are common. Typically they are caused by direct blows to the elbow (e.g. motor vehicle accidents), and due to falls when the triceps are contracted. [1] [3] "Side-swipe" injury when driving a motor vehicle with an elbow projecting outside the vehicle resting on an open window's edge is an example. [4]
Direct trauma: This can happen in a fall with landing on the elbow or by being hit by a solid object. Trauma to the elbow often results in comminuted fractures of the olecranon.
Indirect trauma: by falling and landing with an outstretched arm.
Powerful pull of the triceps muscle can also cause avulsion fractures.
To assess an olecranon fracture, a careful skin exam is performed to ensure there is no open fracture. Then a complete neurological exam of the upper limb should be documented. [5] [2] Frontal and lateral X-ray views of the elbow are typically done to investigate the possibility of an olecranon fracture. [1] A true lateral x-ray is essential to determine the fracture pattern, degree of displacement, comminution, and the degree of articular involvement.[ citation needed ]
There are several classifications that describe different forms of olecranon fractures, yet none of them have gained widespread acceptance: [5]
Based on the stability, the displacement and the comminution of the fracture. It is composed of three types, and each type is divided in two subtypes: subtype A (non-comminuted) and subtype B (comminuted).
This classification incorporates all fractures of the proximal ulna and radius into one group, subdivided into three patterns:
In fractures with little or no displacement, immobilization with a posterior splint may be sufficient. [1] Elbows may be immobilized at 45°–90° of flexion for 3 weeks, followed by limited (90°) flexion exercises.[ citation needed ]
Most olecranon fractures are displaced and are best treated surgically: [1]
Tension band fixation is the most common form of internal fixation used for non-comminuted olecranon fractures. [5] It is typically reserved for noncomminuted fractures that are proximal to the coronoid. [2] This procedure is performed using Kirschner wire (K-wires) which converts tensile forces into compressive force. [2]
Single intramedullary screws can be used to treat simple transverse or oblique fractures. [5] Plates can be used for all proximal ulna fracture types including Monteggia fractures, and comminuted fractures. [2]
This method is indicated for cases when open reduction and internal fixation is unlikely to be successful. For example: extensive comminutions, elderly patients with osteoporotic bone, and small or non-union fractures. [5] [2]
Olecranon fractures are rare in children, constituting only 5 to 7% of all elbow fractures. This is because in early life, olecranon is thick, short and much stronger than the lower extremity of the humerus. [5]
However, olecranon fractures are a common injury in adults. This is partly due to its exposed position on the point of the elbow.[ citation needed ]
The ulna is a long bone found in the forearm that stretches from the elbow to the smallest finger, and when in anatomical position, is found on the medial side of the forearm. That is, the ulna is on the same side of the forearm as the little finger. It runs parallel to the radius, the other long bone in the forearm. The ulna is usually slightly longer than the radius, but the radius is thicker. Therefore, the radius is considered to be the larger of the two.
The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.
In human anatomy, the ulnar nerve is a nerve that runs near the ulna bone. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest in the human body unprotected by muscle or bone, so injury is common. This nerve is directly connected to the little finger, and the adjacent half of the ring finger, innervating the palmar aspect of these fingers, including both front and back of the tips, perhaps as far back as the fingernail beds.
The radius or radial bone is one of the two large bones of the forearm, the other being the ulna. It extends from the lateral side of the elbow to the thumb side of the wrist and runs parallel to the ulna. The ulna is usually slightly longer than the radius, but the radius is thicker. Therefore the radius is considered to be the larger of the two. It is a long bone, prism-shaped and slightly curved longitudinally.
A Colles' fracture is a type of fracture of the distal forearm in which the broken end of the radius is bent backwards. Symptoms may include pain, swelling, deformity, and bruising. Complications may include damage to the median nerve.
A bone fracture is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. In more severe cases, the bone may be broken into several fragments, known as a comminuted fracture. A bone fracture may be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture.
A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. Symptoms include pain, bruising, and rapid-onset swelling. The ulna bone may also be broken.
A Smith's fracture, is a fracture of the distal radius.
The olecranon, is a large, thick, curved bony eminence of the ulna, a long bone in the forearm that projects behind the elbow. It forms the most pointed portion of the elbow and is opposite to the cubital fossa or elbow pit. The olecranon serves as a lever for the extensor muscles that straighten the elbow joint.
In the human arm, the humeral trochlea is the medial portion of the articular surface of the elbow joint which articulates with the trochlear notch on the ulna in the forearm.
The olecranon fossa is a deep triangular depression on the posterior side of the humerus, superior to the trochlea. It provides space for the olecranon of the ulna during extension of the forearm.
The Monteggia fracture is a fracture of the proximal third of the ulna with dislocation of the proximal head of the radius. It is named after Giovanni Battista Monteggia.
The humeroradial joint is the joint between the head of the radius and the capitulum of the humerus, is a limited ball-and-socket joint, hinge type of synovial joint.
Bennett fracture is a type of partial broken finger involving the base of the thumb, and extends into the carpometacarpal (CMC) joint.
A humerus fracture is a break of the humerus bone in the upper arm. Symptoms may include pain, swelling, and bruising. There may be a decreased ability to move the arm and the person may present holding their elbow. Complications may include injury to an artery or nerve, and compartment syndrome.
The elbow is the region between the arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa, and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body. The term elbow is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used.
A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. In children, many of these fractures are non-displaced and can be treated with casting. Some are angulated or displaced and are best treated with surgery. In children, most of these fractures can be treated effectively with expectation for full recovery. Some of these injuries can be complicated by poor healing or by associated blood vessel or nerve injuries with serious complications.
The Hume fracture is an injury of the elbow comprising a fracture of the olecranon with an associated anterior dislocation of the radial head which occurs in children. It was originally described as an undisplaced olecranon fracture, but more recently includes displaced fractures and can be considered a variant of the Monteggia fracture.
An ulna fracture is a break in the ulna bone, one of the two bones in the forearm. It is often associated with a fracture of the other forearm bone, the radius.
{{cite book}}: CS1 maint: others (link){{cite book}}: CS1 maint: others (link)