Olecranon and Coronoid Process Fractures

Fractures of the olecranon affect the humeroulnar joint. The flexion–extension of the elbow is often compromised by several mechanisms: loss of continuity of the extensor apparatus and destabilization of the elbow in some cases. In severe forms, associated lesions of the radial head and/or coronoid process are common. Determining the most appropriate option for an individual fracture is based on analysis of radiographs and CT scans, including three-dimensional reconstruction. Accurate fracture classification can greatly influence management recommendations and ultimate prognosis. If nondisplaced fractures can be treated with a short period of immobilization, most often these lesions require precise and stable osteosynthesis, allowing immediate postoperative rehabilitation. It is generally carried out by figure-of-eight tension band wire fixation for simple transverse fractures or by ulnar dorsal plate fixation in more comminuted fractures. The treatment of associated lesions is important: osteosynthesis of the coronoid process and of the radial head. In displaced fractures, functional treatment or excision of an olecranon fragment is solution of last resort, especially in the elderly, when the stability of the elbow is not compromised.