Nonoperative management of olecranon fractures in the working age patient: A case series

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-07-05 DOI:10.1016/j.jcot.2025.103119

Huub H. de Klerk , Robert K. Wagner , Devon T. Brameier , Jacob S. Borgida , Abhiram R. Bhashyam , Nishant Suneja

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引用次数: 0

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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工作年龄患者鹰嘴骨折的非手术治疗：一个病例系列

背景手术治疗是大多数工作年龄患者鹰嘴骨折的标准治疗方法。然而，在这一人群中，非手术治疗可能是由于非损伤原因。目前关于鹰嘴骨折非手术治疗的文献仅限于低需求的老年人群。本研究旨在报道工作年龄患者鹰嘴骨折的非手术治疗后的结果。方法回顾性分析2016年至2023年在两家一级创伤中心接受非手术治疗的18-65岁鹰嘴骨折患者，随访≥3个月。临床结果在中位12周（IQR: 9-29）收集，包括活动范围和并发症。放射学愈合评估的中位时间为18周（IQR: 9-30）。通过电话调查收集8例患者中位时间为3年（IQR: 2-4）的长期Mayo肘部功能评分（MEPS）和臂、肩、手快速残疾（QuickDASH）结果。结果17例Mayo 1A型骨折9例（50%），2A型骨折5例（28%），2B型骨折4例（22%）。中位年龄为50岁（IQR: 31-55岁）。所有梅奥1型骨折在最后随访时均显示完全愈合或渐进式愈合迹象。5例（56%）梅奥2型骨折无愈合迹象，但保留了功能活跃的屈伸弧线。MEPS和QuickDASH结果（可用于6例梅奥1型骨折和2例梅奥2型骨折）差异很大，6例（75%）患者能够进行所有评估的日常生活活动，4例（50%）报告持续疼痛。结论梅奥1型鹰嘴骨折的非手术治疗效果满意。梅奥2型骨折可导致功能性骨不连伴可变疼痛。患者报告的长期预后可能有很大差异，这两种骨折类型都需要进一步研究。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.