Fragment-specific Plate Fixation in a Case of Mayo Type IIB Olecranon Fracture: A Case Report.

Abstract

Introduction: Olecranon fractures account for 5-7% of elbow fractures, making them a common injury. The majority of these fractures are treated surgically because they are intra-articular and can disrupt the elbow extensor mechanism. Mayo Type II fractures are displaced with a stable ulnohumeral joint, indicating intact ligamentous structures, particularly the anterior portion of the medial collateral ligament.

Case report: In our case report, a male in his 20's came to the outpatient department with complaints of pain in the right elbow since 1 day following a fall from a bike. He also reported that he was unable to fully extend his right elbow. After a plain radiograph, a right displaced comminuted olecranon fracture was suggested. He underwent a pre-anesthesia checkup and standard laboratory testing before being taken for surgery. Open reduction internal fixation with fragment-specific plates was done. An above-elbow slab in the extended position was applied post-surgery and continued for 14 days. Elbow range of motion physiotherapy was started in accordance with tolerance, and the patient responded favorably to surgery.

Conclusion: To effectively categorize olecranon fractures according to displacement, comminution, and stability, the Mayo classification was developed. With appropriate computed tomography scan imaging and pre-operative planning, individual fragments of these comminuted fractures can be delineated, and fragment-specific implants can be used, resulting in good radiological and clinical outcome with minimal complications as compared to tension band wiring.