Olecranon stress fractures are one of the three types of fractures that may occur in the olecranon in throwing and overhead athletes 1.
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Epidemiology
Olecranon stress fractures predominantly occur in throwing and overhead athletes including sports such as baseball, gymnastics, weight lifting, tower-diving and javelin 2.
Pathology
Olecranon stress fractures occur due to a valgus hyperextension overload syndrome secondary to repeated pulling of triceps brachii, and associated microinjury, which exceeds the bone's intrinsic ability to self-repair 1.
Five sites of stress injuries have been described 2:
- olecranon apophyseal line (skeletally immature)
- metaphyseal olecranon
- oblique mid-olecranon
- transverse proximal olecranon
- olecranon tip
Radiographic features
Fractures may be subtle and not be seen on a radiograph. CT or MRI are both more sensitive in detecting stress responses and fractures 1.
Treatment and prognosis
Most stress fractures heal by conservative management. In recalcitrant cases, particularly when non-union is present, surgical management using internal screw fixation may be required 1.