Comminuted olecranon fracture requires surgical intervention. Plate fixation has been performed on the majority of cases. We reviewed the cases of comminuted olecranon fracture in young and middle age treated by plate osteosynthesis and analyzed the functional outcome, complications and ratio and timing of hardware removal. Fifteen cases of comminuted olecranon fractures treated by plate fixation were reviewed. Bone union was achieved in all cases, the average range of motion at the final follow up was −11° in extension, 133° in flexion, 89° in pronation and 88° in supination. Hardware removal performed in 12 cases in average 8.3 months postoperatively, in 2 cases elbow joint contracture release was performed during the hardware removal. In the co-payment (+) group, 4 cases (67%) removed the plate at average six months postoperatively. On the other hand, no co-payment group (workman’s compensation insurance or automobile liability insurance) underwent hardware removal surgery in 8 cases (89%) at 9.6 months postoperatively. There was no statistical difference between the timing or prevalence of hardware removal between the groups. The present study showed high removal rate of hardware despite the excellent clinical result. The surgeons should be aware that plate fixation of the olecranon fracture requires the removal of a plate in the majority of cases.
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