Management

The most important aspect of management for this foal is to reduce the olecranon fracture in order to allow functionality of the triceps apparatus.  This will enable the foal to bear weight.  This fracture will require open reduction.  We will place a narrow dynamic compression plate on the caudal aspect of the olecranon.  This will provide compression at the fracture site.  It will also neutralize the forces of the triceps being put on the fragment.  The plate must be contoured to fit the curved olecranon process.  This plate has oval holes that allow the screw head to displace the plate as it is tightened against the bone.  After the proximal side of the plate is attached to the bone, the placement of the distal half of the plate will draw the fragments together.  We need to ensure that the articular surface is correctly reduced.  A lag screw should be placed in the proximal fragment and cross the fracture line.  Two more cortical screws will be placed on the proximal fragment on the caudal aspect of the bone, perpendicularly to the plate.  We will use three short cortical screws (also perpendicularly to the plate) on the caudal side of the bone, distal to the fracture.  The important point here is to avoid entering the radius with the screws.  This will prevent the disruption of the normal growth of the radius.  If the ulna is transfixed to the radius, there is the possibility of subluxation and eventually degenerative joint disease as a result of the deformation.   We will place a protective bandage over the suture site to protect the site from contamination.  
	The foal will be confined to stall rest for six to eight weeks.  His weight-bearing should be restored immediately.  If he is not weight-bearing right away, we will recommend splinting the carpus in extension for added support.  We will recheck radiographs in two weeks for signs of repair and for integrity of the plate.  At this time, we may check for any nervous deficits, especially of the radial nerve.   If the foal is appropriately weight-bearing, this is not as much of a concern.  
	Intraoperatively, IV antibiotics will be administered at the time of surgery.  We will begin a course of the appropriate antibiotics for ten to fourteen days.  The foal will also receive a high dose, longer acting Phenylbutazone orally for seven days.   



Prognosis

The prognosis for an olecranon fracture is good.  The foal should return to normal function provided no complications arise.  Possible complications include compensatory lameness, infection of the surgery site, degenerative joint disease, and failure of fixation.