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Bones of the Upper Limb: Ulna

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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Coronoid fractures and complex elbow instability: current concepts.

Panagiotis Masouros¹, Petros Christoforos Christakakis², Paraskevi Georgiadou²

¹6th Orthopedic KAT General Hospital of Attica.

Orthopedic Reviews

|June 7, 2024

Summary

This study reviews complex elbow instability, focusing on coronoid process fractures. It guides management based on fracture type, recommending fixation for anteromedial facet and basal fractures, and reconstruction for chronic deficiencies.

Keywords:

anteromedial facet coronoid elbow instability terrible triad trans-olecranon fracture dislocation

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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.