Pilot report: non-operative treatment of Mayo Type II olecranon fractures in any-age adult patient

Shoulder Elbow. 2017 Oct;9(4):285-291. doi: 10.1177/1758573217711889. Epub 2017 Jun 5.

Abstract

Background: We report on the non-operative treatment of Mayo Type II olecranon fractures.

Methods: Fourteen isolated Mayo Type II olecranon fractures were treated non-operatively, followed to discharge, and retrospectively reviewed. Treatment was splinting in extension followed by protected active motion beginning 3 weeks to 4 weeks post-injury. Mayo Elbow Performance Index (MEPI) and Shortened Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores were available in 86% and 64% of cases, respectively. Follow-up radiographs were obtained.

Results: At discharge, the mean (SD) MEPI score was 95 (5). The mean (SD) elbow motion arc was 121° (21°). One patient re-fractured his elbow after discharge by falling on the ice. He recovered after open reduction and internal fixation. One patient (documented Marfan syndrome) developed an asymptomatic non-union. Excepting the patient who fell, no patient received additional care.

Conclusions: In this pilot report, Mayo Type II olecranon fractures were treated non-operatively to discharge. Good to excellent results were obtained in all patients according to the MEPI. Supportive care of these fractures should be comparatively studied. A downside risk to providing supportive care for these fractures was not identified.

Keywords: MEPI; QuickDASH; closed olecranon fracture; nonoperative care; splinting; type 2 olecranon fracture.