Since the fetlock joint will not fully open in any position, the collateral ligament is detached using an iatrogenic condylar fracture, which is created with a bone saw.
Note: An alternate technique involves the transection of the lateral collateral - and the metacarposesamoidean ligament, instead of the iatrogenic condylar fracture.
The fragment is rotated palmarly/plantarly to allow luxation of the fetlock joint and exposure of the articular surface.
The cartilage is subsequently removed from the joint surfaces followed by the preparation of short 3.2 mm osteostixis holes in all joint surfaces.
At this point, the technique varies depending on how the tension band is created – by using the proximal sesamoid bones and the distal sesamoidean ligament or by using a wire.