Greater sigmoid notch of the olecranon disruption in a minimally displaced pediatric olecranon fracture: A case report

No definitive treatment guidelines exist for pediatric olecranon fractures. We describe a 14-year-old boy who sustained an olecranon fracture after a bicycle fall. Radiographs and computed tomography showed <2 mm of displacement and a step-off, findings indicating conservative care. However, the greater sigmoid notch (GSN) contour appeared abnormal, and magnetic resonance imaging revealed marked disruption. Surgical treatment was performed to restore the GSN arc. At 2 years, the patient had full, painless motion and symmetric olecranon morphology. Even in patients with <2 mm of displacement and minimal step-off, greater disruption of the sigmoid notch contour may occur. Thus, treatment planning should include careful evaluation of the GSN contour.