title: Spontaneous bilateral olecranon fractures in a rheumatoid patient.
abstract: A case is described of a patient sustaining bilateral spontaneous olecranon fractures while undergoing rehabilitation following surgery for a hip fracture. The patient's underlying rheumatoid arthritis disease process most likely caused erosions and subchondral cysts formation in the mid-trochlear notch region. This area, in turn, acts as a pivot point in elbow extension/flexion movements. During rehabilitation, the patient became dependent on her upper limbs for mobilisation. This led to significant forces being put through this already weakened region, causing spontaneous bilateral olecranon fractures. Rheumatoid patients after lower limb surgery should be careful during rehabilitation, and avoid undue strains through their upper limbs.
authors.affiliation: Department of Orthopaedics, Chesterfield Royal Hospital NHS Trust, Chesterfield, UK. ymmij26@hotmail.com
authors.forename: Sayyied
authors.initials: S
authors.lastname: Kirmani
authors.forename: Kingsley
authors.initials: K
authors.lastname: Draviaraj
authors.forename: Babu
authors.initials: B
authors.lastname: Madegowda
authors.forename: Shantanu
authors.initials: S
authors.lastname: Shahane
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000534:rehabilitation / Q000601:surgery; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology*; D006801:Humans