ArticleJournal of clinical orthopaedics and trauma2025
Nonoperative management of olecranon fractures in the working age patient: A case series.
Article in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Operative treatment is the standard of care for the majority of olecranon fractures in working-age patients. However, nonoperative management may be indicated for non-injury reasons in this population. Current literature on nonoperative management for olecranon fractures is limited to the low-demand geriatric population. This study aimed to report outcomes following primary nonoperative management of olecranon fractures in working-age patients. Methods: All consecutive patients aged 18-65 years managed nonoperatively for an olecranon fracture at two Level 1 Trauma Centers between 2016 and 2023 with ≥3 months follow-up were retrospectively identified. Clinical outcomes were collected at a median of 12 weeks (IQR: 9-29) and included range of motion and complications. Radiographic healing was assessed at a median of 18 weeks (IQR: 9-30). Long-term Mayo Elbow Performance Score (MEPS) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcomes were collected by telephone survey for 8 patients at a median of 3 years (IQR: 2-4). Results: Seventeen patients with 9 (50 %) Mayo type 1A, 5 (28 %) type 2A, and 4 (22 %) type 2B fractures were identified. The median age was 50 years (IQR: 31-55). All Mayo type 1 fractures demonstrated either complete healing or progressive signs of healing at final follow-up. Five (56 %) Mayo type 2 fractures demonstrated no evidence of healing but preserved a functional active flexion-extension arc. MEPS and QuickDASH outcomes (available for 6 Mayo type 1 fractures and 2 Mayo type 2) varied greatly, with 6 (75 %) patients able to perform all assessed activities of daily living and 4 (50 %) reporting persistent pain. Conclusion: Nonoperative treatment for Mayo type 1 olecranon fractures leads to satisfactory healing. Mayo type 2 fractures may lead to functional nonunion with variable pain. Long-term patient-reported outcomes may vary considerably and should be subject of further study for both fracture types. Level of evidence: Level IV.
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