Coronoid fractures and complex elbow instability: current concepts.

Area of Science:

• Orthopedic Surgery
• Traumatology
• Elbow Biomechanics

Background:

• Coronoid process fractures are often part of complex elbow injuries like terrible triads and Monteggia-like lesions.
• These injuries involve specific fracture patterns and soft-tissue damage.
• The O'Driscoll classification categorizes coronoid fractures into tip, anteromedial facet, and basal types.

Purpose of the Study:

• To review common complex elbow instability patterns.
• To identify indications for coronoid process fracture fixation.
• To guide appropriate management strategies for these fractures.

Main Methods:

• Review of literature on complex elbow instability and coronoid process fractures.
• Analysis of fracture patterns associated with specific injury types.
• Evaluation of surgical management techniques based on fracture classification.

Main Results:

• Tip fractures, often in terrible triads, may not require direct fixation if elbow stability is achieved post-operatively.
• Anteromedial facet fractures are best managed with buttress plating.
• Large basal fractures can be effectively treated with posteroanterior screw fixation.

Conclusions:

• Management of coronoid process fractures should be tailored to the specific fracture type and associated injuries.
• Surgical fixation techniques vary, including buttress plating and screw fixation.
• Coronoid reconstruction using grafts is an option for chronic coronoid deficiency.