Non-operative management of olecranon fractures may be indicated in specific populations or when patients opt for conservative measures after shared decision making. In these instances, thorough understanding of operative and non-operative treatment outcomes can equip upper extremity surgeons with requisite knowledge to inform practice-specific fracture management pathways. We hypothesized that non-operative management of unilateral, isolated olecranon fractures results in satisfactory patient outcomes in terms of function, range of motion, and pain.
After IRB approval, retrospective chart review was conducted on adults (>18 years) with unilateral, isolated olecranon fractures at a single multispecialty orthopaedic practice from 2010 to 2024. Exclusion criteria included polytrauma and open injuries. Demographics, injury characteristics, fracture care management, complications, and functional outcomes were collected. Descriptive statistics were performed using SPSS version 28 (IBM, Armonk, NY, USA).
There were 180 patients (79 male, 101 female) that presented with unilateral, isolated olecranon fractures. Mean age at presentation was 59.2 (SD 21.6) years. Fracture laterality was 55.6% left and 44.4% right. 53.3% were displaced, and 46.7% were non-displaced. Mean time in splint or cast was 23.4 (SD 15.8) weeks and 20.2 (SD 15.4) weeks for displaced and non-displaced fractures, respectively (p=0.29). Mean time from initial presentation to last follow-up visit was 24.0 weeks.
At last follow-up visit, mean degrees of elbow extension and flexion were 0.0 (SD 11.7) and 129.3 (SD 13.9), respectively. Mean degrees of supination and pronation were 70.7 (SD 18.0) and 74.7 (SD 14.1), respectively. For pain assessment, mean visual analog scale (VAS) at last follow-up visit was 0.93 (SD 2.22) and 0.76 (SD 1.78) for displaced and non-displaced fractures, respectively (p=0.44).
• Unilateral, isolated olecranon fractures managed non-operatively yielded near-full elbow range of motion in all directions at last follow-up visit.
• Elbow range of motion was comparable between displaced and non-displaced fractures managed non-operatively.
• Pain assessment at last follow-up visit resulted in low VAS scores for both displaced and non-displaced fractures, thus indicating favorable pain management outcomes with non-operative management of unilateral, isolated olecranon fractures.
• This study describes the largest cohort of adult patients managed non-operatively for unilateral, isolated olecranon fractures.
