title: Surgical Management of Symptomatic Olecranon Traction Spurs.
abstract: BACKGROUND
  There is a paucity of information pertaining to the pathoanatomy and treatment of symptomatic olecranon traction spurs.
  
  
  OBJECTIVE
  To describe the pathoanatomy of olecranon traction spur formation, a technique for spur resection, and a series of patients who failed conservative care and underwent operative treatment.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Eleven patients (12 elbows) with a mean age of 42 years (range, 27-62 years) underwent excision of a painful olecranon traction spur after failing conservative care. Charts and imaging studies were reviewed. All patients returned for evaluation and new elbow radiographs at an average of 34 months (range, 10-78 months). Outcome measures included the Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire; the Mayo Elbow Performance Score (MEPS); visual analog scales (VAS) for pain and patient satisfaction; elbow motion; elbow strength; and elbow stability.
  
  
  RESULTS
  The traction spur was found in the superficial fibers of the distal triceps tendon in all cases. The mean QuickDASH score was 3 (range, 0-23), the mean MEPS score was 96 (range, 80-100), the mean VAS pain score was 0.8 (range, 0-3), and the mean VAS satisfaction score was 9.6 (range, 7-10). Average elbow motion measured 3° to 138° (preoperative average, 5°-139°). All patients exhibited normal elbow flexion and extension strength, and all elbows were deemed stable. Early postoperative complications involved a wound seroma in 1 case and olecranon bursitis in 1 case: both problems resolved without additional surgery. Two patients eventually developed a recurrent traction spur, 1 of whom underwent successful repeat spur excision 48 months after the index operation.
  
  
  CONCLUSIONS
  Short- to mid-term patient and examiner-determined outcomes after olecranon traction spur resection were acceptable in our experience. Early postoperative complications and recurrent enthesophyte formation were uncommon.
  
  
  CONCLUSIONS
  This study provides the treating physician with an improved understanding of the pathoanatomy of olecranon traction spur formation, a technique for spur resection, and information to review with patients regarding the outcome of surgical management.
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Hasham M
authors.initials: HM
authors.lastname: Alvi
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Kalainov
authors.affiliation: Midwest Orthopaedics, Rush University Medical Center, Chicago, Illinois, USA.
authors.forename: Debdut
authors.initials: D
authors.lastname: Biswas
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Soneru
authors.affiliation: Midwest Orthopaedics, Rush University Medical Center, Chicago, Illinois, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cohen
keywords: enthesophytes; olecranon bursitis; olecranon traction spurs; triceps tendinosis; weight lifting