Table 1.

Technical pearls.

Technical Pearls	Rationale
Use a non-absorbable braided suture	Has similar strength and fatigue properties to steel wire therefore will not elongate significantly under load
Compress and reduce the fracture with a pointed reduction clamp	The suture will maintain compression once the clamp is removed and act as a tension band but is not used as a reduction tool
Maintain at least a 10-mm bone bridge between the dorsal ulna cortex and the transverse drill hole	Aligns suture parallel to the the long axis of the ulna shaft and minimizes the risk of tunnel fracture
Ensure grasping bites in the triceps are as close to bone as possible	Ensures closer suture contact with bone which improves construct stability
Use two separate sutures and tie two knots	Results in more sutures crossing the fracture site in different orientations and acts as a fail safe if one suture loosens
Tighten the sutures and tie the knots with the elbow extended	Generates compressive forces at the fracture site when the elbow is flexed and minimizes slack in the system
Tie the knots on the lateral aspect of the ulna and bury them underneath anconeus during closure	Avoids knots close to the ulna nerve and prevents knot prominence through the skin