Olecranon Fracture

The olecranon is the hard bony tip at the back of your elbow — the part you'd hit if you landed straight on your elbow. The triceps muscle, which straightens your arm, attaches to it. Olecranon fractures usually happen from a direct hit (falling onto a hard surface) or from the triceps yanking a chunk of bone off all at once during a sudden, forceful contraction. When the fragment shifts out of place, the triceps can no longer pull through it — your arm loses its ability to straighten — and you need surgery to put it back together.

• Pain and swelling at the back of the elbow — immediate after the fall or impact, centered right over the bony tip.
• Inability to straighten the arm against gravity — the triceps can't pull through the broken bone, so the arm hangs bent and won't extend on its own.
• Palpable gap or step at the fracture site — you may feel a dip or notch where the bone has split apart under the skin.
• Bruising spreading down the forearm — within a day or two, blood from the fracture tracks down the back of the forearm.

Pain and swelling at the back of the elbow, plus an arm that can't straighten against gravity, is the classic story. Sometimes you can feel a step or gap where the bone has split. Front and side X-rays confirm the fracture and show how far the pieces have moved apart.

If the fragment has pulled apart and you can't straighten your arm, surgery is the way to put the pieces back, lock them with hardware, and restore the triceps' pull — without it, the bone often fails to heal and the elbow stays weak.

External patient-education references and related OSI pages for additional background:

• Britannica — Bone disease (fractures)
• Britannica — Joint (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language