Proximal Ulnar Reinsertion of the Triceps Brachii Tendon with a Synthetic Implant in a Dog with Nonreconstructible Olecranon Fracture

Objective Reporting the reinsertion of the triceps brachii onto the proximal ulna as a salvage procedure in a dog with nonreconstructible olecranon fracture. Case Description A Labrador Retriever was presented with a comminuted olecranon fracture. Initial fracture stabilization was unsuccessful, resulting in implant failure and a nonreconstructible comminuted fracture, thus preventing triceps tendon reattachment. Revision surgery was performed after the implants and bone fragments were removed. A synthetic implant was sutured onto the triceps tendon and fixed on the proximal ulna by an interference screw (IS) in a bone tunnel. A transarticular Jean-Alphonse Meynard external fixator was applied for 3 weeks. Results After 3 weeks, the dog had moderate lameness with a painless elbow. At 1.5 months, it had severe lameness with a painful elbow and mild osteoarthritis (OA). Nonsteroidal anti-inflammatory drugs were prescribed, and intensive physical therapy was initiated. Lameness improved at 2.5 and 3.5 months despite mild OA. At 9 months, the dog had mild lameness and a swelling of the elbow. Radiographs showed moderate OA and lucency around the IS. Bacteriologic examination was positive. The implants and infected tissues were removed, and antibiotics were prescribed for 1 month. At 18 months, the dog had mild lameness with no pain. At 33 months, it had intermittent mild lameness with no pain, yet severe OA. Conclusion Triceps tendon re-insertion onto the proximal ulna yielded satisfactory long-term outcome in this dog with nonreconstructible olecranon fracture.