A persistent olecranon physis is relatively rare; a fracture through the persistent olecranon physis in an adult is particularly rare. Little is known about the pathology of this disease. We report a case of a 36-year-old man presenting with right elbow pain after he had slipped and hit his elbow, with a history of a persistent symptomatic olecranon physis when he was a junior high school baseball player. He had been diagnosed with a fracture through a persistent olecranon physis by another doctor. Ten weeks after the injury, an iliac autograft was inserted and internal fixation was achieved with Kirschner wires and a figure-of-eight tension band in our hospital. Histologically, a fracture passed through the persistent physis cartilage and degeneration of the remnant of the physis was observed. The remnant of the physis at the olecranon side had not been replaced by new bone, though the physis at the distal ulnar was nearly replaced by new bone. The patient returned to work without experiencing pain or limitation in the range of motion 6 months after the operation. Radiographic evidence of bone union was seen after removal of internal fixation at the 13-month follow-up.
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