Surgical resection of the olecranon bursa may be complicated by wound healing problems. Treatment with debridement and primary skin closure can be attempted. We reviewed eight patients in whom this approach had failed. In four patients we achieved wound healing with a pedicled flap (three antecubital fasciocutaneous island flaps and one radial forearm flap). In three patients the wound healed after closure of the skin and immobilization of the elbow in extension. In one elderly patient with diabetes and rheumatoid arthritis an antecubital fasciocutaneous island flap failed. It can be concluded that the antecubital fasciocutaneous island flap and primary closure of the skin followed by immobilization of the elbow in extension can be used to treat chronic wounds at the olecranon.