Duckworth olecranon elderly RCT

Prospective randomised trial of non-operative versus operative management of olecranon fractures in the elderly.

Duckworth AD, Clement ND, McEachan JE, et al. The bone & joint journal 2017 · PMID 28663405 · doi:10.1302/0301-620x.99b7.bjj-2016-1112.r2

Randomised trialManagementElbowCitation checked

Question: In older adults with displaced olecranon fractures, is surgical fixation better than non-operative treatment?
Design: Randomised controlled trial from Edinburgh (UK).
Patients: Patients aged 75 and over with displaced olecranon fractures.
Intervention: Operative fixation (tension band wiring or plate)
Comparison: Non-operative management with early mobilisation
Primary outcome: DASH score at 1 year
Key result: No significant difference in DASH or other functional scores at any point; the operative group had an unacceptably high complication rate and the trial was stopped early for this reason.
Limitations: Stopped early with a small sample, limiting precision.
Impact on practice: UK evidence supporting non-operative care for displaced olecranon fractures in frail older patients, accepting radiological nonunion.