A Simple and Safe Technique of Olecranon Osteotomy

Abstract

Chevron osteotomy of the olecranon during the posterior approach of the elbow joint has become universally common. We modified the technique to see if it is better than the standard technique to perform, reconstruct and finally evaluate the results. A prospective study was done in 17 cases of comminuted distal humeral intercondylar fractures. A modified osteotomy was done using a Gigli saw instead of a power saw. The indications remained the same. After fixing the distal humerus fracture, the olecranon fragment was stabilised with tension band wire technique. The post-operative management was similar to that of standard AO technique. There were no per-operative difficulties with the new technique. The osteotomy was easy to do with no risk of damage to the distal humeral cartilage, as the direction of the osteotomy was away from the joint. Gigli saw produced congruent antero-posterior chevron surfaces which helped the fragment to sit well in its trough with good bony apposition. Stable reduction of the olecranon facilitated easy fixation. In this series, all osteotomies united well. There were no osteotomy-related complications. Two cases had prominent wires which were removed after the union of the osteotomy. We feel that this osteotomy is easy to perform, safe and takes less time than the standard technique, though a comparative study in a large number of cases by different surgeons needs to confirm the benefits.