Background: Open reduction and internal fixation (ORIF) for olecranon fractures remains a challenge. Due to intra-articular extension of fractures, anatomical reduction and stable rigid fixation is essential to obtain good functional outcome. We evaluated the functional outcomes of olecranon fracture fixation using pre-contoured anatomical locking olecranon plate.

Methods: A prospective study was conducted on 14 patients (Mayo types 1B, 2A, and 2B) between age of 18 to 73 years who went surgical treatment through open reduction and internal fixation with anatomical olecranon plate between September 2021 to September 2023. These patients were followed up for 12 months (minimum 6 months) and evaluated based on union time, range of motion and functionally by Mayo elbow performance score. 

Results: The mean age was 47 ± 17.9 years. The mean bone union time was 12.86 ± 1.23 weeks. At 6 months, the mean MEPS was 95.71 ± 1.54. No significant differences were found between different Mayo groups for union time (p=0.554) or MEPS (p =0.663). Complications occurred in 21.4% (3/14) due to hardware prominence. Radiological osteoarthritis (Broberg & Morrey) was noted in 35.7% (5/14) of cases (Grade 1: n=4; Grade 2: n=1), despite 100% anatomical reduction with step off and gap of ≤ 2 mm).

Conclusion: Anatomical locking plates appear to be an effective surgical option for Mayo type 1 and 2 fractures in this small series. However, larger comparative studies are required to establish long-term superiority over traditional methods.

Keyword: Anatomical olecranon plate, MEPS score, Olecranon fracture