Non-surgical functional treatment for displaced olecranon fractures in the elderly

• Published in: The bone & joint journal Vol. 96-B; no. 4; p. 530
• Main Authors: Gallucci, G L, Piuzzi, N S, Slullitel, P A I, Boretto, J G, Alfie, V A, Donndorff, A, De Carli, P
• Format: Journal Article
• Language: English
• Published: England 01-04-2014
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Casts, Surgical; Elbow Joint - injuries; Elbow Joint - physiopathology; Female; Fracture Fixation - adverse effects; Fracture Fixation - methods; Fractures, Bone - diagnostic imaging; Fractures, Bone - rehabilitation; Fractures, Bone - surgery; Humans; Male; Olecranon Process - diagnostic imaging; Olecranon Process - injuries; Patient Satisfaction; Radiography; Range of Motion, Articular; Retrospective Studies; Treatment Outcome; Non-surgical treatment; Olecranon fracture; Functional treatment; Elderly patients; Conservative; Elbow fracture
• ISSN: 2049-4408
• DOI: 10.1302/0301-620x.96b4.33339

We retrospectively evaluated the clinical and radiological outcomes of a consecutive cohort of patients aged > 70 years with a displaced fracture of the olecranon, which was treated non-operatively with early mobilisation. We identified 28 such patients (27 women) with a mean age of 82 years (71 to 91). The elbow was initially immobilised in an above elbow cast in 90° of flexion of the elbow for a mean of five days. The cast was then replaced by a sling. Active mobilisation was encouraged as tolerated. No formal rehabilitation was undertaken. At a mean follow-up of 16 months (12 to 26), the mean ranges of flexion and extension were 140° and 15° respectively. On a visual analogue scale of 1 (no pain) to 10, the mean pain score was 1 (0 to 8). Of the original 28 patients 22 developed nonunion, but no patients required surgical treatment. We conclude that non-operative functional treatment of displaced olecranon fractures in the elderly gives good results and a high rate of satisfaction.