This narrative review by Hak and Golladay systematically examines how to select and execute treatment for olecranon fractures across the full spectrum of injury patterns — from nondisplaced fractures managed nonoperatively to complex fracture-dislocations requiring plate fixation — with biomechanical rationale for each approach.
When you see a simple transverse olecranon fracture, tension-band wiring is your workhorse — but bury those K-wire ends under the triceps or you will be taking hardware out.
When you see comminution, distal extension past the trochlear notch midpoint, coronoid involvement, or a Monteggia pattern, reach for a dorsal LC-DC plate with bone graft rather than trying to force a tension-band construct that will fail.
This narrative review by Hak and Golladay systematically examines how to select and execute treatment for olecranon fractures across the full spectrum of injury patterns — from nondisplaced fractures managed nonoperatively to complex fracture-dislocations requiring plate fixation — with biomechanical rationale for each approach.
When you see a simple transverse olecranon fracture, tension-band wiring is your workhorse — but bury those K-wire ends under the triceps or you will be taking hardware out.
When you see comminution, distal extension past the trochlear notch midpoint, coronoid involvement, or a Monteggia pattern, reach for a dorsal LC-DC plate with bone graft rather than trying to force a tension-band construct that will fail.