Arthroscopy-assisted fixation of coronoid process fractures: technical description and case series

The ulnar coronoid process is a primary static stabilizer of the elbow and its fractures, when associated with joint instability, usually require surgical treatment. Conventional open techniques may be difficult to perform and require wide surgical exposure, with greater morbidity and risk to neurovascular structures, in addition to causing injury to other healthy tissues, increasing the risk of fibrosis, stiffness, infection, and decreasing the vascularization of the fracture fragments. The objective of this study was to describe an arthroscopic technique and to present the results of a series of patients with fractures of the ulnar coronoid process associated with elbow instability treated with arthroscopy-assisted transosseous fixation using high-strength sutures. Thirteen patients were retrospectively evaluated, with a mean age of 30.0 years and a mean follow-up of 22.0 months. Bone union was achieved in all cases. The mean final flexion was 130.3°, with a mean extension deficit of 7.3°. The mean final protonation and supination were 88.8° and 86.9°, respectively. The mean functional score was 10.7 on the QuickDASH and 92.6 on the MEPS. Arthroscopy-assisted transosseous fixation proved to be a reliable option in the treatment of coronoid process fractures associated with instability, allowing early mobilization, a low complication rate, and good clinical and functional results, provided that it is performed by surgeons experienced in elbow arthroscopy.