Doornberg, J Bone Joint Surg Am 2006 - Fracture of the Anteromedial Facet of the Coronoid Process

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Fracture of the Anteromedial Facet of the Coronoid Process

Doornberg, Ring·J Bone Joint Surg Am·2006·174 citations·Retrospective cohort

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Background

Fracture of the anteromedial facet of the coronoid was recently recognized as a distinct type of coronoid fracture resulting from a varus posteromedial rotational injury force. Very few reports are available to help guide the management of these injuries.

Methods

18 patients with a fracture of the anteromedial facet of the coronoid process were treated over a 6-year period.
12 patients were treated for the acute fracture, and 6 were managed after initial treatment elsewhere.
All but 3 patients (2 with concomitant fracture of the olecranon and one with a second fracture at the base of the coronoid) had avulsion of the origin of the lateral collateral ligament complex from the lateral epicondyle.
The initial treatment was operative in 15 patients and nonoperative in 3.
The coronoid fracture was secured with a plate applied to the medial surface of the coronoid in 9 patients, a screw in one patient, and sutures in one patient.
It was not repaired in the remaining 7 patients.

Results

At the final evaluation, an average of 26 months after the injury, 6 patients had malalignment of the anteromedial facet of the coronoid with varus subluxation of the elbow, which was due to the fact that the fracture had not been specifically treated in 4 patients and to loss of fracture fixation in 2 patients.
All 6 had development of arthrosis and a fair or poor result according to the system of Broberg and Morrey.
The remaining 12 patients had good or excellent elbow function.

Conclusions

Anteromedial fractures of the coronoid are associated with either subluxation or complete dislocation of the elbow in most patients. Secure fixation of the coronoid fracture usually restores good elbow function.

Copyright remains with the authors and publisher.

Fracture of the Anteromedial Facet of the Coronoid Process

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Fracture of the Anteromedial Facet of the Coronoid Process

Doornberg, Ring·J Bone Joint Surg Am·2006·174 citations·Retrospective cohort

|

Background

Fracture of the anteromedial facet of the coronoid was recently recognized as a distinct type of coronoid fracture resulting from a varus posteromedial rotational injury force. Very few reports are available to help guide the management of these injuries.

Methods

18 patients with a fracture of the anteromedial facet of the coronoid process were treated over a 6-year period.
12 patients were treated for the acute fracture, and 6 were managed after initial treatment elsewhere.
All but 3 patients (2 with concomitant fracture of the olecranon and one with a second fracture at the base of the coronoid) had avulsion of the origin of the lateral collateral ligament complex from the lateral epicondyle.
The initial treatment was operative in 15 patients and nonoperative in 3.
The coronoid fracture was secured with a plate applied to the medial surface of the coronoid in 9 patients, a screw in one patient, and sutures in one patient.
It was not repaired in the remaining 7 patients.

Results

At the final evaluation, an average of 26 months after the injury, 6 patients had malalignment of the anteromedial facet of the coronoid with varus subluxation of the elbow, which was due to the fact that the fracture had not been specifically treated in 4 patients and to loss of fracture fixation in 2 patients.
All 6 had development of arthrosis and a fair or poor result according to the system of Broberg and Morrey.
The remaining 12 patients had good or excellent elbow function.

Conclusions

Anteromedial fractures of the coronoid are associated with either subluxation or complete dislocation of the elbow in most patients. Secure fixation of the coronoid fracture usually restores good elbow function.

Copyright remains with the authors and publisher.

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