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Nonunion of Nonoperatively Treated Displaced Olecranon Fractures
Wendy E. Bruinsma, MD1; Anneluuk Lindenhovius, MD, PhD1; Michael D. McKee, MD, FRCSC2; George S. Athwal, MD, FRCSC3; David Ring, MD, PhD1
1Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston; 2Professor, Division of Orthopaedics, Department of Surgery, St. Michael's Hospital and the University of Toronto, Toronto, ON, Canada; 3The Hand and Upper Limb Centre, St Joseph's Health Care, University of Western Ontario, London, ON, Canada

Purpose: To report the outcomes of patients with non-union after displaced olecranon fractures that underwent no treatment or intentional nonoperative management. We hypothesized that the majority of these patients would be satisfied with their symptoms and function.  

Methods: Ten patients (six women and four men) with an average age of 59 years (range, 21 to 94 years) presented to one of seven surgeons with nonunion of a displaced fracture of the olecranon an average of 17 months (range, 3 months to 7 years) after injury.  

Results: The average flexion-extension arc at presentation was 117° (range, 100° to 135°) with an average flexion of 137° (range, 120° to 150°) and an average extension of 21° (range, 10° to 40°). Forearm rotational arc averaged 172 degrees (range, 150° to 180°) with an average pronation of 86° (range, 75° to 90°) and an average supination of 86° (range, 75° to 90°). Two patients that had difficulty participating in daily activities because of pain or loss of function requested operative treatment.   

Discussion: Patients that present with a nonunion after a displaced olecranon fracture managed non-operatively have reasonable elbow function and uncommonly request operative treatment.  

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