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Ballistic Olecranon Fracture with Triceps Advancement.
Score and Comment on this Case
Clinical Details
Clinical and radiological findings: An 18-year-old male sustained a ballistic injury to the elbow. Radiological assessment revealed a non-reconstructible olecranon fracture with an intact distal humerus. Ligamentous structures including the coronoid, lateral ulnar collateral ligament (LUCL), and medial collateral ligament (MCL) were intact, and there was sufficient triceps muscle for advancement.
Preoperative Plan
Planning remarks: The preoperative plan involved excision of the fragmented olecranon and advancement of the triceps tendon to restore elbow stability. Given the intact ligamentous structures, no additional ligamentous reconstruction was planned.
Surgical Discussion
Patient positioning: The patient was positioned supine with the affected arm placed on an arm table to allow optimal access to the posterior aspect of the elbow.
Anatomical surgical approach: A posterior longitudinal incision was made over the elbow, extending proximally over the triceps. The olecranon fragments were excised, and the triceps tendon was advanced and reattached to the proximal ulna using suture anchors to ensure stability.
Operative remarks:The surgeon noted that despite the significant bone loss, the intact ligamentous structures allowed for a stable reconstruction with triceps advancement. This approach minimized the risk of post-traumatic arthritis and provided a stable elbow joint in a complex injury scenario.
Postoperative protocol: Postoperatively, the patient was placed in a hinged elbow brace allowing early range of motion exercises. Weight-bearing activities were restricted for 6 weeks, with gradual progression to full activities as tolerated.
Follow up: Not specified.
Orthopaedic implants used: Suture anchors for triceps tendon reattachment.
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21 Jul 2025
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Full Citation
Cite this article:
Surname, Initial. (2025). Ballistic Olecranon Fracture with Triceps Advancement.. Journal of Orthopaedic Surgery and Traumatology. Case Report 13715596 Published Online Jul 21 2025.