Anterior approach for fixation of isolated type III coronoid process fracture

Soo-Hong Han, Hyung-Ku Yoon, Seung-Yong Rhee, Jun-Ku Lee
European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie 2013, 23 (4): 395-405
Authors chose anterior approach through the antecubital fossa for better exposure in that case of isolated coronoid process fracture. The objective of the study was to report validity of anterior approach for the Regan and Morrey type III, isolated fracture of the coronoid process of the ulna without residual valgus or varus instability. From January 2007 and January 2010, we evaluated eleven consecutive patients (7 men, 4 women; mean age 44 years; range 25-67 years) who underwent surgical fixation through the anterior approach. The mean follow-up period was 21 months (range 15-34 months). Preoperative and follow-up roentgenograms were evaluated for assessment of the fracture configuration and confirmation of fracture union. Clinical evaluation included an analysis of surgical complication, range of motion, Mayo elbow performance score, and DASH (disability of the arm, shoulder, and hand) score. Fractures were mainly fixed with plate and screws in 8 cases, cannulated screws in 3 cases. There was no residual joint instability after fracture fragment fixation. All fractures were united, and the average union time was 15.2 weeks with a range of 11-20 weeks. Mean flexion contracture of the elbow was 3.6° (range 0°-10°), and further flexion was 130.9° (range 125°-140°) at the last follow-up. Mean Mayo elbow performance score was 92.3 (range 80-100 points), and mean DASH score was 5.9 (range 1.6-8.3 points). In conclusion, Primary fixation of the coronoid process fractures through the anterior approach could be particularly useful in the Regan and Morrey type III isolated coronoid process fractures.

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