Caudolateral approach to Olecranon/Ulna
1. Skin incision
The skin and subcutaneous tissues are incised beginning slightly proximal to the most proximal aspect of the olecranon (in the foal the apophysis of the olecranon) and extends distally between the muscle bellies of the ulnaris lateralis cranially and the superficial digital flexor caudally.
The exact length and position of the incision needs to be adjusted to the size of the horse and the location of the fracture.
2. Deep dissection
The plane of dissection continues between the ulnaris lateralis and the deep digital flexor muscle bellies to expose the caudal aspect of the distal olecranon and proximal ulna. In cases where the incision is extended further distally, care must be taken to avoid traumatization of the ulnar nerve, which is running between these muscle bellies from the mid-portion of the radius/ulna further distally.
Further exposure of the proximal olecranon is required for plate application and is accomplished by sharply elevating and dissecting the dense fibrous connective tissue attachments at the site where the plate will be applied.
Additional proximal dissection over the most proximal aspect of the olecranon between the fibers of insertion of the triceps muscle is required to allow the highly contoured aspect of the plate to be applied in this location for fractures of the proximal olecranon.
