Use of String of Pearls Locking Plate System, Intramedullary Pin and Lag Screws for the Treatment of an Intra-Articular Olecranon Fracture in a Lamb

Darby W Walmsley,Tania Shaw,Simon T Kudnig

doi:10.1055/s-0039-1700844

Abstract

Abstract Objectives The aim of this study was to describe a case of an intra-articular olecranon fracture in a lamb repaired using a String of Pearls locking plate system, intramedullary pin and lag screws. Materials and Methods A 6-month-old, 20 kg, purebred male Merino lamb was referred for evaluation of a non-weight bearing lameness of the left thoracic limb of unknown duration. Orthogonal radiographic assessment of the left elbow revealed a complete, closed, long sagittal oblique, minimally displaced fracture of the olecranon involving the ulnar shaft at the level of the radial physis, extending proximally through the distal semilunar notch to the mid-body of the olecranon. The fracture was repaired using a String of Pearls locking plate system spanning both the proximal radius and olecranon, an intramedullary pin in the ulna and lag screws across the fracture line. Results Orthogonal radiographic assessment of the left elbow at 8 weeks postoperatively revealed implant quiescence with radiographic union of the fracture site. Long-term telephone follow-up at 3 and 6 months postoperatively found the patient was no longer restricted in activity, with free access to the field, and was not displaying an overt lameness. Clinical Significance The authors describe a novel method to treat an intra-articular in a lamb olecranon fracture in a lamb using a String of Pearls locking plate system, intramedullary pin and lag screws.

Highlights

Correction of proximal ulna and olecranon fractures is extensively described in veterinary literature.[1,2,3,4,5,6,7,8,9] Their prevalence is, somewhat uncommon when compared with other antebrachial fractures
Clinical Significance The authors describe a novel method to treat an intra-articular in a lamb olecranon fracture in a lamb using a String of Pearls locking plate system, intramedullary pin and lag screws
Open reduction and internal fixation with application of a tension band wiring (TBW) have been proposed as the treatment of choice for proximal ulna fractures in dogs, but is associated with a higher complication rate than plate osteosynthesis (PO).[3]

Summary

Introduction

Correction of proximal ulna and olecranon fractures is extensively described in veterinary literature.[1,2,3,4,5,6,7,8,9] Their prevalence is, somewhat uncommon when compared with other antebrachial fractures Such fractures may be non-articular or articular in nature, with the latter most common, and have been reported in dogs,[1,2,3] cats,[1] horses[4,5,6,7,8] and a bull.[9] To counteract the tensile force of the triceps brachii muscle group on the olecranon, various repair techniques, including tension band wiring (TBW) and plate osteosynthesis (PO), have been described to convert tensile forces to compressive forces while achieving interfragmentary compression and anatomical reduction.[1,3,4] Open reduction and internal fixation with application of a TBW have been proposed as the treatment of choice for proximal ulna fractures in dogs, but is associated with a higher complication rate than PO.[3]. The ulna bone characteristically tapers along its diaphyseal received July 23, 2019 accepted after revision September 24, 2019

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