Elbow Case 1 ED Management

There are many classification systems of olecranon fractures, none of which are universally accepted.

Typically, nondisplaced fractures can be treated by immobilization in 45 to 90 degrees of flexion, ice, and analgesia with outpatient orthopedic evaluation. Nondisplaced olecranon fractures should follow-up for repeat films in order to ensure that displacement does not occur.

Generally, displaced fractures, fractures of the articular surface, fracture/dislocations, and fractures with ulnar nerve injury require ED orthopedic consultation. Many will require open reduction and internal fixation though some injuries in the elderly may be treated conservatively. Patients with ulnar nerve impairment can be informed that most injuries with nerve involvement are a result of a contusion and will resolve spontaneously.