Coronoid process fractures
Asses elbow in relation to other associated soft tissue and bony injuries (see fracture dislocations)
Classification
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Regan and Morrey classification (1989)I. Small fleck of bone II. 50 % of the height of the coronoid process or less III. More than 50 % of the height of the coronoid process. |
Type I fracture not avulsion fracture nothing inserts onto tip, shearing fracture.
Illustration above artificial may have associated fracture of radial head. Coronoid fractures may be very small and often appear as a very small triangular fragment in the coronoid fossa on the lateral. These small coronoid fragments are often difficult to distinguish from fragments of the radial head. If any uncertain get CT. (see latest article)
Instability rises and prognosis deteriorates with increasing amount of coronoid involvement. Fracture of base of coronoid compromises stability by decreasing dimension of trochlea notch and the anterior band of the medial collateral ligament inserts into the fractured coronoid fragment.
The terrible-triad
- Dislocation of elbow
- Radial head fracture
- Fracture coronoid process
Treatment
See fracture dislocation need to consider overall elbow stability
References
JBJS - A 71:1348-1354. (1989) - Fractures of the coronoid process of the ulna.