Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of posterior elbow pain and swelling following a direct blow/fall onto the flexed elbow. Reports inability to actively extend the elbow against gravity, localized tenderness over the olecranon process, and associated ecchymosis. No distal neurovascular deficits reported.
Clinical Examination Findings
Inspection reveals significant swelling and ecchymosis over the posterior elbow. Palpation demonstrates a palpable gap at the olecranon process with exquisite tenderness. Active extension of the elbow is absent or severely limited. Distal neurovascular status is intact, with palpable radial/ulnar pulses and normal capillary refill. Sensation to light touch is preserved in the ulnar, median, and radial nerve distributions.
Treatment Protocol
Immobilization in a long arm posterior splint with the elbow in 45-90 degrees of flexion. Analgesia provided. Orthopedic consultation requested for definitive management, likely ORIF (Open Reduction Internal Fixation) given the intra-articular nature and disruption of the extensor mechanism.