Plate fixation of olecranon osteotomy

The olecranon osteotomy may be repaired using a precontoured olecranon plate.

Reduce and hold the osteotomy with pointed reduction forceps to apply compression.

Pearl: To prevent the reduction forceps from slipping on the distal fragment, a small hole can be drilled in the distal fragment before applying the forceps.

Pearl: Incise the distal triceps in line with the ulna down to the bone to allow the plate to sit closer to the olecranon tip.

Apply the plate to the dorsal aspect of the olecranon and use K-wires or forceps to maintain its position.

Apply the plate to the dorsal aspect of the olecranon and use forceps to maintain its position.

Using the forceps to maintain the compression, place bicortical screws distal to the osteotomy and unicortical screws proximal to the osteotomy avoiding violation of the olecranon articular surface.

It is also desirable to place a long oblique screw crossing the osteotomy site beneath the articular surface.

Confirm stability of the fixation and range of motion, including supination/pronation. Check for plate impingement within the olecranon fossa with elbow extension.

Final x-rays or image intensifier views should demonstrate good reduction and proper hardware position.