- Discussion:
- displaced, stable frx;
- frx fragments are displaced > 2-3 mm, but collateral ligaments are intact;
- frx may be non-comminuted (Type IIA) or
comminuted (Type IIB).
- no sign of subluxation;
- Non Operative Treatment:
- immobilized in mid flexion, these fractures will heal in 3-4 weeks;
- the main complication is loss of motion which will vary in severity;
- Operative Treatment:
- operative treatment depends on age of patient;
- w/ pt > sixty years old,
comminuted frags are removed & triceps is advanced;
- its important to reattach the triceps tendon as closely as possible to articular surface of the ulna;
- this is best technique when pt desires only one operation w/ satisfactory elbow function;
- w/ pts < sixty years old, consider 3.5-mm AO dynamic-compression plate
contoured to fit fractured olecranon following reduction;
- this neutralizes forces across coronoid frx from tip of olecranon to shaft;
- distance between coronoid process & olecranon must not be shortened by compression of the comminuted fragments;
- always explain to patient beforehand that plate may require future removal;
