Excision and advancement in the treatment of comminuted olecranon fractures.

Comminuted fractures of the olecranon (Mayo type IIB) present a unique challenge to the surgeon as it can be difficult or impossible to entirely preserve the olecranon's normal articulation with the trochlea of the humerus. In this article, we describe a modification of a previously described technique for reconstructing these fractures when a stable anatomic reduction and fixation is not possible. In this method, the comminuted fragments are excised and the proximal olecranon fragment is advanced past the resulting defect and fixed to the distal ulna. Clinical follow-ups from 2 cases are presented; satisfactory preservation of range of motion and elbow stability were achieved in each case.