Traditional versus alternative olecranon osteotomy. Historical review and biomechanical analysis of several techniques.

Olecranon osteotomy for visualization of the distal humerus has a high complication rate. Two basic osteotomies, intra-articular and extra-articular, are in current use. Each is examined using the engineering technique of free-body analysis. The osteotomy fragment mechanics are found to influence both the nature of the fixation and the clinical outcome. In addition to the advantages gained from not disrupting the joint surface, oblique extra-articular osteotomy may have mechanical advantages over transverse intra-articular osteotomy because of decreased osteotomy surface distraction force with triceps contraction.