The treatment of olecranon fractures by excision or fragments and repair of the extensor mechanism: historical review and report of 12 fractures.

The operative treatment of olecranon fractures is controversial. Proponents of open reduction and internal fixation cite restoration of anatomy and rigid fixation, while proponents of excision of fracture fragments with repair of the extensor mechanism cite few complications and a rapid return of motion and function. An extensive review of the literature is presented, outlining the arguments in favor of each procedure. A series of cases is also presented. We report the results after excision of fragments and repair of the extensor mechanism for all 17 patients who underwent this procedure during the past 10 years at our hospitals. Evaluation included subjective, clinical, and radiographic assessment to provide a clinical score. Among the 12 patients with sufficient follow up to be rated, there were 7 excellent results, 4 good results, and 1 poor result. There were no complications. Our patients had a rapid return of motion and function with a rapid return to the preinjury level of activity. We believe the indications for this procedure may be even broader than suggested in the literature.