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Soft tissue attachments of the ulnar coronoid process. An anatomic study with radiographic correlation
D J Cage1, R A Abrams, J J Callahan
1Department of Orthopedics, University of California, San Diego 92103, USA.
Clinical Orthopaedics and Related Research
|November 1, 1995
Summary
Coronoid fractures can cause elbow instability due to their size and impact on stabilizers. Larger fractures, like Type III, involve more critical elbow stabilizers, increasing instability risks.
Area of Science:
- Orthopedic Surgery
- Anatomy
Background:
- Elbow instability often accompanies coronoid fractures.
- The Regan and Morrey classification links fracture size to dislocation incidence.
Purpose of the Study:
- To investigate the anatomical relationship between coronoid fracture fragments and key elbow stabilizers.
- To correlate stabilizer attachment points with coronoid fracture types.
Main Methods:
- Dissection of 20 cadaveric elbows.
- Radiographic analysis of medial collateral ligament, anterior capsule, and brachialis muscle insertion sites on the coronoid.
- Radiopaque labeling of stabilizer insertions.
Main Results:
- The anterior bundle of the medial collateral ligament inserts dorsally, potentially involving only Type III fragments.
- Capsular insertion is rarely at the coronoid tip, making Type I fractures unlikely avulsions.
- The brachialis muscle insertion extends distally, with only Type III fragments large enough to include it.
Conclusions:
- Coronoid fracture instability is related to the size of the fragment and the stabilizers it displaces.
- The Regan and Morrey classification correlates with the involvement of key elbow stabilizers.