Retrospective analysis of 29 fractures of the olecranon process of the equine ulna

SUMMARY Twenty-nine fractures of the olecranon process of the ulna in horses treated at The Ohio State University College of Veterinary Medicine from 1973 through 1983 were evaluated. The objectives of the study were to determine the prognosis for various configurations of fractures of the olecranon process of the ulna, to determine what preoperative factors influenced the prognosis, and to evaluate the efficacy of the treatment methods used. The fractures were placed in one of 4 categories on the basis of severity of the injury: type-1 fractures involved the physeal plate; type-2 fractures involved the olecranon at the level of the anconeal notch (narrowest cross-sectional area of the ulna); type-3 fractures involved the proximal portion of the olecranon without involving the elbow joint; and type-4 fractures were severely comminuted fractures. Three modes of treatment used were: (1) open reduction and internal fixation, using a tension band plate, (2) elbow to ground splinting, with stall rest, and (3) stall rest alone. Internal fixation with a tension band plate was 68% successful. Of those horses in which repair was considered successful, 84% returned to excellent function. Elbow to ground splinting with stall rest was used successfully for nonarticular and nondisplaced fractures in 2 horses. Stall rest alone resulted in 28% “pasture sound” horses, with none of the 7 horses so treated returning to athletic performance. On the basis of this study, the following conclusions were derived. (1) Nonarticular/nondisplaced fractures are candidates for nonsurgical treatment, using full-limb splinting, stall rest, and periodic reevaluation. (2) Displaced fractures and articular fractures should be treated by open reduction and internal fixation, using a tension band plate. (3) Stall rest alone is not recommended because it results in low percentage and low quality recoveries.