A Combined Tension Band and Lag Screw Technique for Fixation of Olecranon Osteotomies

A combined tension band and lag screw technique for fixation of olecranon osteotomies was used in six canine clinical patients weighing 4.5 to 19 kg. After the proximal part of the ulnar shaft was exposed, a screw hole was drilled and tapped just cranial to the caudal cortex of the olecranon. An osteotomy was performed and the hole in the olecranon fragment was overdrilled to form a gliding hole. For reconstruction, the olecranon was reduced anatomically and compressed with a screw placed in lag fashion. With the trochlear notch exposed, a Kirschner wire was inserted cranial to the screw, using care not to enter the elbow joint. A double-twist figure-eight tension band wire was placed around the Kirschner wire in five dogs and around the screw in one dog. In this dog, a spiked washer was used with the screw because a small olecranon fragment had been produced by incorrect osteotomy position. A painful soft tissue swelling over the prominent washer, which resolved after implant removal, was the only complication attributed to the technique. The combined tension band wire and lag screw technique was a rapid and reliable method for fixation of olecranon osteotomies.