The olecranon is the posterior prominence of the proximal ulna that fits into the olecranon fossa of the humerus during elbow extension, forming the point of the elbow and the bony block to hyperextension. The triceps tendon inserts on its posterior surface, while its anterior surface forms the upper part of the trochlear notch. Its subcutaneous position makes it vulnerable to direct trauma and the site of olecranon bursitis.
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| Ossification | The olecranon apophyseal ossification centre appears at about age 8 to 11, sometimes in two parts, and fuses with the ulnar shaft at age 14 to 16, remaining open during adolescence and vulnerable to traction apophysitis. |
Olecranon fractures from direct trauma or falls on the point of the elbow disrupt the triceps mechanism, producing an inability to extend the elbow. Simple transverse fractures are fixed by tension band wiring, which converts triceps pull into compression across the fracture, while comminuted fractures need plate fixation. Olecranon stress fractures and posteromedial osteophytes (valgus extension overload) affect throwing athletes. Olecranon bursitis may follow repeated pressure or a single blow, gout or pseudogout, or infection, and septic bursitis needs aspiration and antibiotics. In adolescent throwers, traction stress at the open olecranon apophysis can delay its fusion.
Bend the elbow to about 90 degrees; the large bony point at the back of the elbow is the olecranon. Its tip forms a triangle with the medial and lateral epicondyles when the elbow is flexed and lies in a straight line with them when the elbow is straight, which is used to check for dislocation.
A fall onto the point of the elbow or forceful triceps pull fractures the olecranon; displaced fractures lose active elbow extension and need fixation.
Swelling of the subcutaneous bursa over the olecranon from pressure, trauma, gout, or infection.
Repetitive triceps loading and valgus extension overload in throwing athletes can cause a stress fracture of the olecranon.
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