Abstract

A 24 year old male, professional discus thrower presented in our orthopedic service with four months history of posterior elbow joint pain and mild impairment in function. He described a "snap" in his right elbow during a regular practice. The standard X-ray showed no particular lesions. The treatment was short physical rest and oral NSAID. He continued to train but with a decrease in performance. Four months later, after the competition season ended, he returned with persistent pain in elbow joint but still with no impairment in elbow function or range of motion (ROM).  An MRI was performed which showed an aspect of  comminutive fracture of the tip of the olecranon incompletely consolidated and a CT (computed tomographic) scan was necessary to confirm the diagnosis. 
The choice for the surgical technique was a challenge because of the particularity of the high functional demands of the patient. The option was an olecranon osteotomy with excision of the small comminuted fragments in the olecranon fossa and osteosynthesis of the olecranon using tension band. The second day after surgery the patient began ROM and was integrated in a specific rehabilitation program. At 9 month the tension band has been surgically removed and he began a regular training program once the wound close. This case report suggests that a tip of the olecranon fracture must be taken in consideration as differential diagnosis in professional throwing athletes and not to be overlooked. It also suggests that olecranon osteotomy with excision of the fragments can be a viable surgical option.