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REVIEW  THE TRAUMATIC ELBOW: CURRENT CONCEPTS 

Minerva Orthopedics 2022 April;73(2):138-61

DOI: 10.23736/S2784-8469.21.04097-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Coronoid fractures

Enrico BELLATO 1, 2 , Andrea PAUTASSO 2, Davide BLONNA 3, Lorenzo MATTEI 1, Antonio MARMOTTI 1, Filippo CASTOLDI 1, 2

1 Department of Orthopedics and Traumatology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy; 2 University of Turin, Turin, Italy; 3 Department of Orthopedics and Traumatology, Mauriziano-Umberto I Hospital, Turin, Italy



Proper management of coronoid fractures is mandatory because missed diagnosis or poor treatment may lead to elbow dysfunction. The main portions of the coronoid are the tip, the base, the anteromedial facet, the sublime tubercle, and the lesser sigmoid notch. Coronoid fractures are typically after elbow dislocation or subluxation. Consequently, collateral ligament tears are often associated, ranging from small to high grade tears. There are two possible mechanisms of injury: posterolateral rotatory instability (PLRI) and posteromedial rotatory instability (PMRI). Nowadays, the most widely used classifications - as the one published by Raegan and Morrey - can be misleading and insufficient since it does not give any information about the possible mechanism of injury. The O’Driscoll classification is three-dimensional and CT scan-based and helps distinguish between PLRI and PMRI mechanism of injury. It classifies coronoid fractures as tip, anteromedial, or basal fractures. Treatment can be based on the O’Driscoll classification and on the analysis of other factors, such as the number and size of fracture fragments and associated lesions. Occasionally, nonsurgical management is a treatment option, but must be selected with caution. Surgical management often consists of fracture fixation (with several options, such as cannulated screws, Kirschner wires, sutures, and dedicated plate and screws) and ligament repair. Arthroscopy may be a treatment option, in particular when there is only one coronoid fragment.


KEY WORDS: Ulna; Fractures, bone; Elbow; Elbow Arthroscopy

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