The history of the injury is usually a result of direct trauma, but injury can occur from indirect force applied by forceful contraction of the triceps while the elbow is flexed.

     Patients have pain, swelling and ecchymosis over the olecranon.  A palpable separation at the fracture site or the inability to extend the elbow against force may be present. A thorough neurovascular examination should be performed with special attention given to the ulnar nerve (up to 10% have ulnar nerve deficits). Motor weakness of the interossei muscles of the hand and loss of sensation on the palmar surface of the fifth digit and hypothenar eminence are indicators of ulnar nerve injury.