Olecranon fractures disrupt the critical interplay between the extensor mechanism and the ulnohumeral articulation. Master the management of olecranon fractures, from assessing active elbow extension to applying the Mayo classification and the 2-30-50 rule. ⏱ Chapters 0:00 Intro 0:17 Essentials 0:44 Classification 1:14 Imaging 1:51 Algorithm 2:30 Tbw 3:06 Plate 3:39 Numbers 4:05 Complications 4:34 Clinical reasoning — Simple 5:04 Clinical reasoning — Complex This OrthoVellum masterclass provides an in-depth exploration of olecranon fractures, a common injury representing roughly ten percent of all elbow trauma. We cover the essential anatomy, biomechanics, clinical assessmentand the Mayo classification framework to guide your surgical decision-making between conservative management, tension band wiring (TBW), and plate fixation. 🦴 IN THIS VIDEO YOU'LL LEARN • How to assess the extensor mechanism and identify when a patient cannot extend against gravity • Applying the Mayo classification system based on fracture displacement, comminutionand elbow stability • Interpreting the true lateral elbow radiograph for anterior ulnar subluxation and terrible triad injuries • The principles and technique of tension band wiring using the TBW mnemonic • Specific indications for choosing plate fixation over tension band wiring using the PLATE mnemonic • Conservative management protocols and criteria for Mayo Type I injuries • Recognising complex trans-olecranon fracture-dislocation patterns • Applying the 2-30-50 rule for articular step-off, obliquityand symptomatic hardware removal thresholds • Considering fragment excision with triceps advancement in elderly, low-demand patients ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Inability to extend the elbow against gravity indicates complete extensor mechanism disruption and demands surgical intervention. ✔️ A fracture displacement or articular step-off greater than 2mm is the primary threshold for surgical fixation. ✔️ Tension band wiring is reserved for simple transverse or short oblique fractures; comminution or obliquity over 30 degrees mandates plating. ✔️ Always scrutinise the lateral radiograph for associated coronoid and radial head fractures indicating a terrible triad pattern. ✔️ Counsel patients pre-operatively that approximately 50% of tension band wiring cases require symptomatic hardware removal, compared to 22% for plates. 👩⚕️ WHO THIS IS FOR This video is designed for orthopaedic trainees, medical studentsand clinicians seeking a comprehensive understanding of elbow trauma. Curious patients looking for detailed, highly technical information on olecranon fracture management will also find it highly valuable. 📚 RELATED TOPICS: Tension Band Wiring Biomechanics and Principles · Trans-olecranon Fracture-Dislocations · The Terrible Triad of the Elbow · Monteggia Fracture Patterns · Proximal Ulna Anatomy and the Coronoid Process · Elbow Instability Assessment 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #orthovellum #olecranonfracture #elbowtrauma #tensionbandwiring #orthopaedicsurgery #fracturefixation #mayoclassification #traumasurgery #orthopedics #elbowsurgery #medicaleducation #bonesurgery #extensormechanism