Arthroscopic and Open Treatment of Olecranon Apophyseal Injuries in the Athlete

Elbow injuries are quite common in the athletic population with overhead throwing athletes at more risk than nonthrowing athletes. These injuries frequently manifest as acute traumatic events or sequela of chronic repetitive stresses on the stabilizing anatomical structures of the elbow. Overuse stress-related olecranon osseous injuries occur in both skeletally mature and immature athletes, and both nonoperative and operative treatment options have provided good outcomes. However, early identification of the injury and appropriate consideration of factors such as age, contralateral physeal closure, fracture displacement, sclerosis, and response to conservative care afford the best opportunity of success with the least risk for surgery, complication, or lost performance. The authors present an alternative classification scheme and treatment algorithm for olecranon injury, including arthroscopic and open surgical techniques for adolescent and young athletes with olecranon stress fractures and both mature and immature radiographic skeletal findings.