What is it?
An olecranon fracture is a fracture to the bony portion of the elbow and usually occurs after a fall or director trauma to the elbow. The fracture may be a simple nondisplaced break or a more complex fracture with dislocation of the elbow joint. Because of the movements required at the elbow, fractures to the olecranon can be complex to treat.
What are the treatment options?
X-rays will help determine the path of treatment that will be taken. Some olecranon fractures can be treated by being casted or placed in a splint to hold the elbow in place while the bone heals. Surgery may be indicated if the elbow is displaced or if the fracture is open. Displaced fractures are treated operatively by internal fixation using wires, screws or plates.
The end goal of treatment is to regain full motion of the elbow and return to normal activities. You will most likely be prescribed physical or occupational therapy which will provide you with exercises to regain full range of motion. Elbows are known to get stiff fairly quickly so it is important to perform given exercises as prescribed multiple times a day to ensure full rehabilitation and return to elbow function that you had prior to injury.
Risks of the Procedure
Patients undergoing any surgery are subject to risks of infection, wound healing problems, nerve injury, deep vein thrombosis and pulmonary embolism. Infection rates are reduced in surgeries that employ smaller incisions. Specific risks related to this injury include loss of elbow joint motion, non-union of the fracture and early onset arthritis of the elbow joint.
What to Expect
The day of the procedure, you will need to arrange for a ride to and from the procedure and arrange for help at home.
Wear comfortable clothing including a button down shirt if possible.
Do not eat or drink anything after midnight for arrivals before noon. Otherwise, do not eat or drink anything seven hours prior to your arrival at the surgery center.
You will be contacted by Lawrence Surgery Center to set up your patient account. They will inform you of your pre-operative instructions as well as tell you when to arrive for surgery.
After surgery your arm will be immobilized. During this time you should perform gentle range of motion exercises with the wrist and finger to keep blood moving and assist with healing. After the immobilization period, you will be put into a range of motion brace to gradually restore full range of motion. Rehabilitation with a physical or occupational therapist will begin once your surgeon feels that the fracture is stable enough to begin regaining the range of motion in your shoulder and elbow.
• You may resume your regular diet. However, start slow with clear liquids and gradually work your way back to your normal diet. This will help prevent nausea and vomiting.
Dressing Care & Bathing
• Keep your dressing, splint and/or sling in place until your first post-operative visit.
• Do not bathe, shower or go swimming until bandages are removed.
• Keep your incision clean and dry until sutures are removed (usually two weeks after surgery).
• Elevating is very important to help keep swelling and discomfort controlled and should be done as much as possible for the first three to five days, then as needed to keep swelling minimized.
• Elevate the affected extremity on pillows with fingertips pointing toward the ceiling.
• It is not necessary to elevate at night, so you may sleep in a comfortable position.
• Wiggle your fingers and thumb frequently to help reduce swelling and to encourage range of motion.
• To help reduce pain and swelling, apply an ice pack to the surgical area for 20 to 25 minutes every one to two hours for the first 48-96 hours and then as needed to help control pain and swelling.
• To avoid frostbite, place a towel or t-shirt between the ice pack and your skin.
• It is not necessary to use ice while sleeping.
• We recommend the use of a cold therapy unit, which is often an out of pocket expense. The advantage of this unit is that the temperature can be regulated, allowing for continuous use for several hours at a time.
• Your physician will give you a written prescription for pain medicine as you leave the surgery center. Take your pain medication as prescribed. You may want to take it regularly for the first 48 hours after surgery. Do not take any additional Tylenol.
• While you are asleep in the operating room, a long acting numbing medication may be injected into the surgical area to help relieve your immediate postoperative discomfort for up to 24 hours. When you first notice tingling or throbbing, begin taking your pain medicine so it will become effective before the local anesthesia wears off.
• No driving while taking any narcotic pain medication!
• The pain medication may cause some nausea so take it with food.
• The pain medication and general anesthesia may also cause constipation, so you may need to take a stool softener, fiber bar, Metamucil or prune juice to prevent constipation.
• Watch for temperature > 101.5F, persistent numbness and tingling in the foot, persistent bleeding or drainage from the wound, foul odor, progressively worsening pain that is unresponsive to pain medication, blue toes, chest pain or difficulty breathing. If you have any of these symptoms, call the office if during normal business hours or go to the nearest emergency room.
• If you do not have a postoperative appointment set-up already, please call the office to schedule an appointment for 7-10 days after surgery at (785)843-9125.
Rehabilitation Plan- Exercises
The prognosis for olecranon fractures is generally excellent and the fracture will typically heal within three months. You will find that you elbow and shoulder become stiff due to the immobilization process. Physical or occupational therapy is typically recommended to regain strength and range of motion. If surgery has been required, the rehabilitation program will be modified to protect the fixation of the fracture fragments.