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

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.

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.

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.