- Discussion:
- if frx extends distally past midpoint of trochlear notch, it no longer represents only a disruption of the triceps mechanism;
- it comprimises stability of elbow in withstanding varus & valgus forces;
- Reduction:
- reduction of olecranon frx is easiest w/ elbow in extension which relaxes the pull of the triceps muscle;
- once reduced, apply towel clamp to frx site;
- consider placing the tips of the two towel clamps in tension band holes;
- Treatment:
- Surgical Approach:
- frx of olecranon which is distal to midpoint of trochlear notch, if not comminuted, such as oblique frx, is first stabilized w/ lag screws;
- K wires are not enough for lateral support;
- to overcome valgus/varus instability distal frxs, need to be supplemented w/ plate, even if fixed w/ lag screws,
- semitubular plates are not strong enough to resist torsional forces;
- one should use the 3.5 mm DC plate to fix these fractures;
- tension wire fixation is not optimal for these distal fractures