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Olecranon Fractures: Classification, Treatment, and Rehabilitation Guidelines

Learn about olecranon fractures, their classification, treatment options including closed reduction and splinting, open reduction and internal fixation (ORIF), and rehabilitation stages to restore elbow range of motion and muscle strength after injury. Discover recommended care protocols and expected recovery times.

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Olecranon Fractures: Classification, Treatment, and Rehabilitation Guidelines

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  1. Olecranon Fractures By: Christine Davis http://www.youtube.com/watch?v=hVc3NQhAw_I&NR=1

  2. Common Mechanism • Falling on flexed elbow when triceps are contracted to help break the fall. • Commonly an avulsion fracture • Direct blow to elbow • Elbow hyperextension

  3. Classification of Olecranon Fractures • Schatzker Classification Transverse transverse impacted Oblique Comminuted Oblique distal Fracture Dislocation

  4. Treatment Goals • Alignment • Articular restoration • Stability • Relationship between humerus and ulna

  5. Treatment • Closed Reduction and Splint or Cast • Used for non-displaced, stable fractures. • Elbow should be held in 90 degrees flexion for 4 weeks.

  6. Treatment Cont. • Open Reduction and Internal Fixation (ORIF) • Recommended if less than 45 degrees of flexion is required to maintain reduction • Method of choice for displaced and comminuted fractures • Fixation Methods • Large intramedullary screw • Tension band • K-wires • Plate & screw • Combination

  7. Day One to Week One • Stability: NONE • ROM: • Surgical: Gentle elbow flexion and AROM in wrist • Cast: No ROM to elbow or wrist • Strength: Isometric wrist strengthening in cast after 3-4 days. • Functional Activities: Only one armed activities with uninjured arm.

  8. Week 2 • Stability: None to minimal • ROM: • Surgical: Active elbow flexion and AROM in wrist • Cast: No ROM • Strength: No strength to elbow in extension. Isometric to elbow and wrist. • Functional Activities: Only one armed activities with uninjured arm.

  9. Four to Six Weeks • Stability: Usually stable with bridging callus • ROM: Active ROM in flexion and extension • Strength: Isometric exercises in flexion and extension • Functional Activities: May use affected arm for stability and light self care.

  10. Six to Eight Weeks • Stability: Stable • ROM: Full AROM to AAROM in all planes to elbow and wrist • Strength: Resistive exercise to elbow and wrist • Functional Activities: May use affected arm for everyday activities

  11. Eight to Twelve Weeks • Stability: Stable • ROM: Full AROM and AAROM in all planes to elbow and wrist. • Strength: Resistive exercise to elbow and wrist • Functional Activities: May use injured arm for everyday activities

  12. Expected Time Lost • Expected time of bone healing: • 10-12 weeks • Expected duration of rehab • 10-12 weeks

  13. Muscle Strengthening • Elbow Muscles • Triceps • Biceps • Pronators • Supinators • Wrist Flexors • Flex. Carpi Radialis • Flex. Carpi Ulnaris • Flex. Digitorum longus and sublimis

  14. Muscle Strengthening Cont. • Wrist Extensor • Ext. Carpi Radialis longus and brevis • Ext. Carpi Ulnaris • Ext. Digitorum longus

  15. Rehabilitation Objectives • Restore Elbow ROM • Maintain Shoulder and Wrist ROM

  16. Rehabilitation Objectives Elbow and Forearm ROM Motion Normal Functional • Flexion 150* 90* • Extension -5*-0* lacking 20-30* • Pronation 90* 50* • Supination 90* 50*

  17. Considerations • Check circulation • Check dermatomes • Skin healing problems due to hardware

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