Anterior approach for operative fixation of coronoid fractures in complex elbow instability

Lee M. Reichel, Graham S. Milam, Charles A. Reitman

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

The coronoid process has been shown to play a critical role in ulnohumeral stability. Coronoid process fractures can occur in isolation or as part of a complex injury pattern. The most common complex pattern, known as the "terrible triad," includes a radial head fracture and elbow dislocation along with the coronoid fracture. Failure to address these fractures and ligamentous injuries can result in recurrent instability and progression to painful arthrosis. Both medial and lateral approaches to the coronoid have been popularized in recent literature, but there is no universally accepted approach. Common fixation techniques include suture lasso, suture anchors, lag screws, and plating all of which have various drawbacks. We describe a direct anterior approach to address coronoid process fractures made in addition to a lateral approach to address radial head and lateral collateral ligament injuries. Coronoid fractures addressed through the anterior approach were stabilized with anterior to posterior screw fixation combined with buttress plating, which allowed anatomic reduction and stable internal fixation at short-term follow-up.

Original languageEnglish (US)
Pages (from-to)98-104
Number of pages7
JournalTechniques in Hand and Upper Extremity Surgery
Volume16
Issue number2
DOIs
StatePublished - Jun 1 2012

Keywords

  • anterior approach to the elbow
  • complex elbow instability
  • coronoid process
  • elbow approaches
  • elbow dislocation
  • elbow fracture-dislocation
  • terrible-triad injury

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