The PAUL technique was developed on the basis of several observations and biomechanical analysis of the canine elbow joint:
- A consequence of medial compartment disease, a subset of elbow dysplasia, is medial collapse of the contact mechanics of the elbow joint;
- Medial collapse overloads the medial compartment, exacerbating existing lameness and joint pain;
- A slight abduction, by 4 – 6 degrees, of the ulna results in an unloading of the medial compartment, alleviating pain;
The PAUL involves an osteotomy of the proximal portion of the ulna. A specially designed ALPS PAUL plate is fixed to impose a corrective limb alignment, aimed at unloading the medial compartment. This new alignment unloads the medial compartment, alleviating lameness, stiffness, and joint pain.