- in elderly pts w/ comminuted frx, excision of up to 50% of olecranon can be well tolerated (no instability)
- if distal surface of semilunar notch of ulna & coronoid are not injured upto 80% of olecranon may be excised w/o producing instability;
- Indications for Excision of proximal fragment & reattachment of triceps:
- elderly patients
- frx must be proximal to middle of trochlear notch ( < 50-80% of joint)
- difficult frx anatomy
- minimal functional demands;
- desire for a single operative procedure;
- Contra-indications to Excision:
- any ligamentous or radial head instability (Type III: frx)
- coronoid process frx (implies disruption of anterior soft tissues);
- surgical approach:
- plan to secure the triceps as close as possible to the articular surface (as opposed to the posterior ulnar surface), so that the triceps tendon acts as
a posterior sling for the elbow joint, promoting stability;
- use non absorbable sutures;
- Post Op:
- post-operative regimen of 3 weeks immobilization followed by protected ROM results in ROM from 10 to 120 deg flexion w/o instability
Operative treatment of olecranon fractures. Excision or open reduction with internal fixation.
Treatment of Olecranon Fractures. Indications for Excision of the Olecranon Fragment and Repair of the Triceps Tendon.
Fracture of the Olecranon Process of Ulna. Treatment by Excision of Fragment and Repair of Triceps Tendon.
Partial olecranon excision: the relationship between triceps insertion site and extension strength of the elbow
Excision and advancement in the treatment of comminuted olecranon fractures.