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Distal Olecranon Fracture

- 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    - if frx extends distally past midpoint of trochlear notch, it no longer represents only a disruption of the triceps mechanism;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