Operative treatment of olecranon fractures. Excision or open reduction with internal fixation.

We reviewed the cases of 107 patients who underwent surgical treatment of an isolated fracture of the olecranon. Fifty-three patients were treated by primary excision and fifty-four, by open reduction and internal fixation by various methods. Static and dynamic strength measurements were obtained from the elbow extensors of twenty-nine patients from these two groups. In the over-all series, the ratings for pain, function, range of motion, elbow stability, and incidence of degenerative joint changes were similar for each group. However, thirteen local complications occurred in the fifty-four patients who had open reduction and two, in the fifty-three who had primary excision. Need for removal of the fixation device led to an additional thirteen procedures in the fixation group. Biomechanical testing demonstrated no significant difference in elbow extensor performance for the two groups.