Harry Hoyen, Simon Lambert, Joideep Phadnis
The olecranon osteotomy may be repaired using a precontoured olecranon plate.
Reduce and hold the osteotomy with pointed reduction forceps to apply compression.
Apply the plate to the dorsal aspect of the olecranon and use K-wires or 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.