Non-Operative Management of a Failed Olecranon Fracture Fixation Leading to Functional Recovery: A Case Report.

An 85-year-old female walker dependent presented with a displaced olecranon fracture following a fall. Open reduction and internal fixation (ORIF) using an anatomic olecranon locking plate was performed. Two-week postoperative X-rays revealed fixation failure with persistent fragment displacement and a wide fracture gap. To manage this condition, non-operative management, including sling immobilization for 4 weeks and progressive physical therapy, was pursued with the elbow at 90 degrees flexion. At the 6-month follow-up, the elbow was pain-free with functional range of motion (ROM) being achieved, and functional independence was observed in daily activities including using a walker. This case highlights the potential for successful functional recovery through non-operative management in geriatric patients as an initial treatment or after a failed ORIF, emphasizing the importance of tailoring treatment to patient-specific factors and functional goals over radiographic outcomes.