Internal Fixation Techniques for Olecranon Fractures of the Ulna

Overview:

Olecranon fractures are common elbow injuries, ranging from simple transverse fractures to complex cases involving adjacent elbow and forearm structures.
Because of the olecranon's subcutaneous position, these fractures are relatively easy to access surgically. However, the superficial location of orthopedic implants often leads to patient dcomplaints about hardware prominence after surgery.

Mechanisms of Injury

1. Indirect Trauma
When falling with the elbow extended, the force is transmitted to the olecranon. The triceps muscle contracts and causes an avulsion fracture. The fracture line may be transverse or oblique, and the fracture fragments are typically displaced.

2. Direct Trauma
A direct impact to the posterior elbow—such as falling directly onto it—can result in a comminuted fracture. These fractures usually present with little or no displacement.

Fracture Classification: Schatzker System

The Schatzker classification, an adaptation of the Colton system, incorporates the biomechanical characteristics of the fracture. It assists in selecting the surgical approach and determining the placement of internal fixation devices.

Type A: Simple transverse fracture

Type B: Transverse compression fracture

Type C: Oblique fracture

Type D: Comminuted fracture

Type E: Distal oblique fracture

Type F: Fracture-dislocation

Choosing the Fixation Method

The choice of fixation technique depends on the fracture type. Both bone screws and locking plate systems are commonly used in these procedures.

Type A: Classic indication for tension band wiring (TBW). Bone screws or plates can also be used effectively.

Type B: Articular surface compression must be identified, reduced, and stabilized using grafts or implants. Fixation similar to Type A.

Type C: Compression is achieved using lag screws, with protection from a tension band or plate (neutralization technique).

Type D: Central fragments are reduced and stabilized with bicortical or intramedullary screws. TBW or plate fixation is chosen based on fracture stability.

Type E: Not suitable for TBW due to mechanical limitations. Trauma locking plates and screws are preferred.

Type F: Complex unstable fractures require comprehensive fixation addressing both bone and soft tissue components.

Surgical Techniques

1) Tension Band Wiring

Fracture stability and joint mobility, especially supination and pronation, should be carefully assessed.

Intraoperative fluoroscopy must confirm that the K-wires have not penetrated the humeroulnar or radioulnar joints.

Postoperative imaging should clearly demonstrate satisfactory fracture reduction and correct positioning of internal fixation.

2) Plate Fixation

Postoperative images

Atom Products

1)Metal Cable System

Material：TC20

Model Number:40102

Spec.: 1.2/1.7

Length: 750mm

2) Locking Plates System

Model number: 4032011

Spec.:  2-12 Holes

Model Number: 4034002

Spec.: 2-8 Holes

About Atom

ATOM Medical Devices Co., Ltd. is a leading manufacturer of standardized orthopedic implants and instruments for global distributors and importers.

We offer a full product range covering trauma, spine, joints, sports medicine, and CMF — all supported by complete surgical instrument sets. Our products are designed for frequent orders, low MOQ, and fast turnaround, making them ideal for emerging markets and high-volume distribution.

With in-house R&D, a certified lab, and modern production lines, we also support OEM/ODM services for partners who need private label or custom solutions.

At ATOM, we focus on reliable, scalable manufacturing — so you can focus on growing your market.