A posterior approach can be used. The triceps may be split or reflected laterally and medially. Olecranon osteotomy is rarely necessary.
Note: Some surgeons prefer a lateral approach as it allows sufficient visualization of the intraarticular component, although access is more limited.
Cleaning of the fracture site
The fracture is cleaned by removing blood clots, loose pieces of bone, and any interposed tissue.
4. Reconstruction of the articular surface
The articular fragments are reduced using pointed reduction forceps, a towel clamp, or with the help of two K-wires.
An anatomical reconstruction of the joint surface (and alignment of the physis) is mandatory.
Definitive interfragmentary fixation
A lag screw is used to obtain interfragmentary compression of the articular fracture plane. A partially or fully threaded screw can be used. If a fully threaded screw is used, it is necessary to overdrill the near fragment.