19 lower-demand elderly patients (>=75) with isolated displaced olecranon fractures were randomized to either operative (tension-band wiring or plate fixation) or nonoperative (immobilization) management. The objective of this trial was to compare functional and patient-reported outcomes between open reduction and internal fixation (ORIF) and nonoperative management over a 1 year period. The results of this trial indicated that both management techniques resulted in significant within-group improvement in function at 1-year; however, there were no significant differences in functional or patient-reported outcomes between groups at any time point. Operative management was associated with a significantly increased rate of complication and increased cost.