Olecranon fracture and flexion

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Hi there,

A month and 3 days ago I had surgery to repair my fractured olcranon. The bone broke into two so the surgeon was able to use a screw to splint the bones together. However there was a chance that this might not work because of the way the bones grab together–they might not line up properly... and this is what happened.

So, long story short, the surgeon used 2 pins and a wire to splint the bones together, which is actually quite common. However, I can't find much information about post operation.

When I left the hospital I was told not to flex my elbow beyond 90 degrees because the triceps will pull the bones apart (being connected to the wire.) After surgery the surgeon seemed very sure to remove the hardware in 6 or so weeks. But I went to a follow up appt. 2 weeks post op and saw a different doctor about the matter... she then told me to start moving my elbow immediately to prevent it from getting stiff, which makes sense. However, she also told me that I can flex beyond 90° and that the hardware genuinely stays forever unless it's bothersome. In that case, it's only removed in 3-6 months.

My concern is that I'm getting two statements that are contradicting meaning that someone's wrong. But I've been following the second doctors words and have been trying to flex my elbow beyond 90°. At the moment I can flex from about 10° to about 90°. Though 90° flexion is difficult and I need to force it. I feel my triceps getting pulled on when I do and it feels near impossible to flex beyond 90°. It begins to hurt, actually. Right where I can feel the pins.

All that being said, should I keep forcing to get flexion beyond 90°? At the moment I'm trying to get ahold of the surgeon who operated but he's a busy man.

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8 Replies

  • Posted

    Hi Nate,. I'm only 5 days post surgery, but I'd think physio would know best. Do you have a referral?

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    • Posted

      Hey there Nancy. I’m actually getting pretty close to a full recovery at this point. The injury happened 5 months ago, here’s an x-ray: https://imgur.com/xnJAa8G .

      I started my physio 2 weeks post surgery while the bone was still broken and only being held together by the hardware (a tension band wire and 2 pins.)

      2 months post surgery is when I really started to notice my movement coming back. However, one of the pins got infected and had to be pulled out early. I was in a splint for 3 days where my elbow had stiffened up again and was told to be very careful (lifting nothing heavier than a “coffee mug) for about 3 weeks, stopping my physio.

      A couple weeks ago I had my other pin removed (4 1/2 months post surgery) and my elbow stiffened up again for a week. However, with both pins removed I’m now able to get close to 100% straightening, since the pin isn’t pinching against the back of the joint. My flex ion was never an issue and I can get, what seems to be pretty close to 100% flexion as well.

      I did take my physio seriously and after 3 months I started training it in the gym, as well. 

      I am still not quite at 100% straightening but since I no longer feel the pinching from the hardware at the back of my elbow and instead feel a stretch inside my elbow, my physio therapist is quite sure that I’ll get it all back. And since the pin was removed I’ve definitely gained range of motion.

      Good luck with your recovery!

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    • Posted

      Thanks Nate for giving a detailed recovery.  I broke my ankle in April of this year, so I know how important/hard physio is.  Fingers crossed this will be my last broken bone!

      Nancy

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    • Posted

      Hey Nate,. I thought I broke my olecranon,but it ended up being my distal humerus. I got to start physio 2 weeks after ORIF but like you I got an infection and had to get another surgery to clean it out and this happened 3 weeks post orif. Physio on hold until stitches removed which put me behind 2.5 weeks. Started physio again! My elbow is always bent and skin feels so tight around my elbow joint (almost like skin is stuck on my metal plate). Lots of scar tissue from two surgeries my physio said. My extension is 165 degrees and flexation is around 100 degrees sad.

      Did you have lots of scar tissue from having multiple procedures on it?

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  • Posted

    Hi Nate...I got my olecranon fracture 3 months back...45 days in splint with immobilise and 45 days physiotherapy I could not get full extension and a 90degree flexion.....the implant is tension band wiring....will it improve by continuous physiotherapy....iam worried a lot
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    • Posted

      3 months ago using tension band wiring practice and you still can’t bend your elbow beyond 90°? I was back at work after 3 1/2 months and the range of motion since then has not changed much and actually gotten worse due to an infection lingering in hardware and the need for another surgery a month back to remove the wire..not pins..that being said the pins are typically removed 3-6 months after surgery and the wire is usually never removed.

      Anyway, everyone is different and I may be a lot younger than you (21) which couldve influenced my return to work in just 3 months.. that being said it could just take longer for you to heal.

      2 months post surgery is where it really started to pick up for me and a lot of my movement came back really quick. I cannot fully straighten my arm but it’s pretty darn close. My flexion has never been a problem and neither has the rotation, if I could get it 100% straight you wouldn’t think anything was different.

      ***ALL that being said, I was never immobilized for 45 days! 2 weeks post surgery I was urged by my surgeon to start physio and start trying to move my elbow right away while the bone was still broken (the hardware held it together but the bones would still clash and rub, which actually helps the bones heal.) the surgery said that if movement does not occur ASAP (typically 2 weeks I believe) then you risk permanent loss of range of motion.

      Why where you immobilized for so long? The elbow stiffens up really quick! It’s one of the most prone joints to stiffness. Even 1 or 2 days of not moving it and the next it’ll be stiff as hell. I’m not surprised that you’re road to recovery is taking so long, 45 days is a long time!

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  • Posted

    Hi,

    ?I broke my Olecranon three weeks ago and have just come out of plaster.  I can't extend my arm fully beyond about 165 degrees and flexing can come beyond 90 to about 110.  The doctor who spoke to me after the nurses removed my cast said no need for physio just rotate the hand lower arm and full arm from the hand. He didn't tell me how long or for how often to do this so I'm doing it whenever I can.  I can feel some strength coming back and a very slight improvement in flexing and extension.  I was told the pins and plate that was fitted to hold the bone together while it heals would be removed if in discomfort but probably after about 6-9months.  What concerns me is if will the current state of extension/flexing stay the same and do I need more physio? The appointment was a bit rushed on the day because there was a problem getting to the hospital and back (due to weather conditions), so I've got an opportunity to speak to the doctors this week and hopefully will find out more then.

    ?Same problem with the surgeon, I don't expect to get hold of him but maybe his secretary will help.  I'm not going to force the joint to move further other than with injured arm, for fear of damaging the pins/plate and making it worse!  I want to go swimming but not sure if this will help at the moment, also driving is a problem because it's painful to change gear!

     

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  • Posted

    To add to my first reply to this thread, the doctor advised me to rotate my arm from my hand with it straight out in front of me and this is helping very gradually (only a week since the cast was taken off).
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