Should an olecranon (elbow bone) spur fracture be splinted?

Management of Olecranon Spur Fractures

Splinting an olecranon spur fracture is useful to reduce pain, reduce risk for further injury, and facilitate transport to a medical facility. 1

Initial Assessment and Management

Splinting Technique

• Apply a rigid splint that immobilizes the elbow joint in the position found
• Do not attempt to straighten a deformed fracture unless necessary for safe transport 1
• Ensure the splint is:
  • Padded adequately to prevent pressure injuries
  • Secured with tape or wrap that is snug but not constrictive
  • Applied in a way that allows monitoring of circulation 2

Wound Management

• If there is an open wound associated with the olecranon spur fracture, cover it with a clean dressing to reduce risk of contamination and infection 1
• Monitor for signs of infection (increased pain, redness, warmth, swelling)

Urgent Medical Attention Indicators

• If the injured extremity appears blue, purple, or pale, activate emergency medical services immediately as this indicates compromised blood flow requiring urgent intervention 1
• Severe pain uncontrolled by basic measures
• Obvious deformity suggesting displacement that might require surgical intervention

Imaging Considerations

• Radiographs are the initial imaging modality of choice for suspected olecranon fractures 1
• Standard views include anteroposterior and lateral projections of the elbow
• If radiographs are normal or indeterminate but clinical suspicion remains high, CT imaging may be necessary to identify occult fractures 1

Treatment Pathway

1. Initial First Aid: Apply splint, manage pain, monitor circulation
2. Medical Evaluation: Radiographic assessment to determine fracture characteristics
3. Definitive Treatment: Based on fracture type, displacement, and patient factors

Common Pitfalls to Avoid

• Attempting to reduce or straighten the fracture without proper training and equipment
• Applying excessive compression that could compromise circulation
• Failing to cover open wounds with clean dressings
• Delaying medical attention when signs of vascular compromise are present
• Removing the splint before proper medical evaluation

Follow-up Considerations

• Olecranon spur fractures may require surgical intervention depending on displacement and stability 3, 4
• Surgical options include tension band wiring, plate fixation, or in some cases, fragment excision 5
• Post-treatment rehabilitation is essential to restore range of motion and strength

By following these guidelines, proper splinting and management of olecranon spur fractures can help reduce pain, prevent further injury, and optimize outcomes while awaiting definitive medical care.