How to target the coronoid from the dorsal cortex.

Area of Science:

• Orthopedic Surgery
• Anatomy
• Biomedical Engineering

Background:

• The coronoid process of the ulna is vital for elbow joint stability.
• Current methods for coronoid process fixation lack a safe, X-ray-free approach.
• A reliable surgical targeting method is needed for optimal elbow stability.

Purpose of the Study:

• To establish a practical surgical range for targeting the ulna coronoid process from the dorsal cortex.
• To normalize this range based on inter-epicondylar distance (IED).
• To provide a safe, X-ray-free technique for coronoid fixation.

Main Methods:

• Analysis of 109 computed tomography (CT) scans.
• Measurement of olecranon to coronoid apex (APEX) and base (BASE) distances.
• Calculation of inter-epicondylar distance (IED) and ratios for normalization.

Main Results:

• Mean APEX: 20.6 mm; Mean BASE: 33.9 mm; Mean IED: 59 mm.
• Ratios of APEX/IED and BASE/IED were calculated (0.3 and 0.6, respectively).
• Significant differences in measurements were observed between males and females (P < .05).

Conclusions:

• A practical range for safe coronoid process targeting from the dorsal ulna cortex has been established.
• A safe surgical approach involves a perpendicular trajectory to the olecranon's dorsal cortex.
• Targeting within 2 to 3.5 cm from the olecranon's most prominent point ensures safety.