Osteology of the coronoid process with clinical correlation to coronoid fractures in terrible triad injuries

Lee M. Reichel, Graham S. Milam, Cody D. Hillin, Charles A. Reitman

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Background: Terrible triad complex elbow fracture-dislocations are represented by elbow dislocations associated with fractures of the coronoid and radial head. Published literature has focused on classifying coronoid fractures by their radiographic morphology on plain x-ray images and computed tomography imaging. No study has specifically related native coronoid osteology to in situ fracture morphology. We identified 3 distinct bony regions of the coronoid, (medial, intermediate, and lateral ridges) with correlation to common fracture patterns associated with terrible triad injuries. Methods: Coronoid osteology in 8 fresh frozen cadaveric elbows was examined, and three distinct ridges were identified and dimensions measured. Results: The measurements were compared with retrospective intraoperative measurements taken of coronoid fracture fragments being stabilized during terrible triad injury repair. Conclusion: Classification of native coronoid process anatomy into functional ridges (medial, intermediate, lateral) may improve our understanding of coronoid fracture patterns in unstable terrible triad injuries.

Original languageEnglish (US)
Pages (from-to)323-328
Number of pages6
JournalJournal of Shoulder and Elbow Surgery
Issue number3
StatePublished - Mar 2013

Bibliographical note

Copyright 2013 Elsevier B.V., All rights reserved.


  • Anatomic study
  • Basic science
  • Cadaver and in vivo
  • Complex elbow instability
  • Coronoid anatomy
  • Coronoid fracture
  • Elbow fractures
  • Terrible triad


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