Painful olecranon physeal nonunion in an adult weight lifter. A case report.

Abstract

Only 3 cases of persistent olecranon physes in adults have been reported previously in literature. In each case, physeal nonunion was present bilaterally and either unilateral, bipartite, or tripartite patellae were present. A case of painful unilateral physeal nonunion in an adult weight lifter is presented. The patient had begun competitive weight lifting when he was 14 years old. Radiographs of the contralateral olecranon and patellae were normal. After failure of conservative treatment, surgical union was achieved, using tension band wiring augmented with autologous iliac crest bone graft. The author proposes that unilateral olecranon physeal nonunion has a mechanical etiology as opposed to a genetic etiology in individuals with bilateral physeal persistence. Surgical treatment in the former group is best delayed until after age 19, to allow adequate time for spontaneous union.