Olecranon fracture
What is Olecranon fracture?
Olecranon fractures is intra-articular fractures that spread to incisura semilunaris. Proximal ulna at the rear for the olecranon process of the skin. And in front of the ulnar coronoid process constitutes a notch and a half months. This notch just block the formation of joint and humerus. Brachial ulnar joint flexion and extension activities only. Anatomic reduction is therefore to prevent joint instability and prevention of osteoarthritis and other complications of effective measures. Olecranon fractures more commonly occurred in adults. Body fractures accounted for 1.17%.
What is causes of Olecranon fracture?
Olecranon fracture causes include Indirect or Directly external force.
Indirect external force: Clearance fell straight at the elbow joint in a position to convey to the outside elbow, triceps avulsion fracture caused by traction. Fracture line may be oblique or transverse. There is separation of the two fracture.
Directly external force: Elbow straight when pulled down, or after a direct blow to the elbow, resulting in fracture, multiple fracture without separation.
1. non-displaced Olecranon fracture: fracture without displacement, which may include crushing, transverse or oblique fractures. X-ray films show fracture separation of 2mm below the elbow against gravity there are activities that stretch the full elbow function.
2. displaced Olecranon fracture: fracture separation in more than 3mm, and no stretch of the elbow against gravity activities. Is divided into the following:
1) Avulsion fracture: more than triceps tendon in an only point occurred. Smaller block fracture. Fracture line more horizontal shape.
2) Transverse or oblique fracture fracture: fracture oblique fracture line more than following the direction of the past. In favor of using screws.
3) Comminuted fracture: caused by more than direct external force, and sometimes an open soft tissue injury.
4) Combined elbow fracture-dislocation: dislocation of the elbow when the former found. Fracture line was oblique or short run. And occurred in the level of coronoid process of ulna with marked shift.
What is symptoms and signs of Olecranon fracture?
Olecranon fracture as a result of an intra-articular fractures, so include symptoms such as internal bleeding and frequent joint effusion, which will lead to olecranon swelling and pain near. Depression fracture can be touched, and accompanied by pain and activity limitation. Can not be anti-gravity extensor elbow elbow is one of the most important signs, which show that the elbow extensor triceps function of the loss of extensor device interrupted the continuity and the emergence of the signs often decide how to determine whether or not treatment. Sometimes because of olecranon fracture associated with ulnar nerve injury, especially in the direct cause serious widespread violence, comminuted fracture, the more associated with ulnar nerve injury, they should be carefully determined before treatment or evaluation to determine the function of the nervous system in order to timely to deal with.
How is Olecranon fracture diagnosis?
Olecranon fracture is diagnosed by X-ray examination: the assessment of olecranon fracture, the most prone to a mistake is not a true lateral X-ray films of the elbow joint. Obtained in the emergency room is often a slight tilt of the lateral X-ray film, it does not sufficiently accurate to determine the length of fracture lines, the extent of crush fractures, and a half notch Department of the scope of the articular surface tear of the radial head, as well as any shift spaces. As far as possible to obtain a true lateral X-ray films of the elbow in order to accurately grasp the characteristics of fracture. Before and after X-ray film is also very important, it can be a fracture line in the direction of the sagittal plane. If the radial head fractures are simultaneous, in the lateral X-ray film along the fracture line can be cut significantly reduced, and there is no angle or displacement.
How is Olecranon fracture treatment?
Purpose for Olecranon fracture treatment should be to achieve a strong and stable elbow extensor. Good range of flexion and extension, and the articular surface of the fine competent. Common treatment for Olecranon fracture are as follows:
1. Functional brake. The various types of non-displaced fracture, cast immobilization after the elbow extensor or the elbow semi-stretched position three weeks to practice after braking activities elbow.
2. Open reduction and internal fixation. There is displacement of cross-sectional or oblique fractures, open reduction should be as far as possible. There are several methods of internal fixation, depending on the choice of the type of fracture. Cancellous bone screw or two cortical bone screws are more commonly used. Satisfaction due to reset, fixed solid in the post 1 ~ 2 weeks, can practice the activities of the elbow joint. Hook plate or tension band wiring of "8" suture is applied to comminuted fractures, external fixation may dispense with the early activities.
3. Fractures block triceps tendon resection and angioplasty. Comminuted fracture serious notch coronoid process with the remote and a half full, viable fracture block resection, but only point triceps tendon layer of cortical bone should be retained for the benefit of its and remote sections suture. If they can not retain a layer of cortical bone, may be turned down triceps tendon fixed to the remote boreholes.
Or open reduction of fracture block resection, fixed in the elbow extensor, and time should be short, about 3 to 4 weeks, except that a fixed, active elbow flexion and extension activities to practice.