Chapter

Coronoid Fracture

In book: Intraarticular fractures, Edition: 2012, Publisher: Jay Pee Publishers, Editors: Dr Rajesh Malhotra, pp.105-114
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    ABSTRACT: Coronoid process fractures are reported to occur from avulsion by the brachialis muscle or to be associated with elbow dislocations. We report a rare case of coronoid process fracture due to avulsion by the anterior bundle of the medial collateral ligament rendering the elbow unstable. In children, small fracture fragments of the coronoid process (types 1 & 2) are in reality often much larger but the actual size is not appreciated radiographically, as the coronoid process contains considerable amounts of cartilage. If the fragment is seen to be significantly displaced it may have resulted from avulsion by important structures such as the medial collateral ligament and open reduction is required to stabilise the elbow.
    Acta orthopaedica Belgica 11/2002; 68(4):396-8. · 0.63 Impact Factor
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    ABSTRACT: Regan and Morrey proposed a 3-type coronoid fracture classification observing that the incidence of concommitant elbow dislocation was proportional to fragment size. Elbow instability associated with coronoid fractures presumably is related to disrupted bony architecture and ineffective stabilizers attached to the free fragment. Twenty cadaveric elbows were dissected, measuring medial collateral ligament, anterior capsule, and brachialis muscle insertion loci on the coronoid. Radiographs were taken after radiopaque labeling of the stabilizer insertions. The anterior bundle of the medial collateral ligament insertion averaged 18.4 mm dorsal to the coronoid tip. Only in Type III fractures would it be attached to the free fragment. The capsule inserted an average of 6.4 mm distal to the coronoid tip. Rarely should Type I fractures result from a capsular avulsion, because only 3 of 20 specimens had the capsule inserting on the tip. The brachialis had a musculoaponeurotic insertion onto the elbow capsule, coronoid, and proximal ulna. The bony insertion averaged 26.3 mm in length, with its proximal margin averaging 11 mm distal to the coronoid tip. In only Type III fractures is the fragment large enough to include the brachialis bony insertion.
    Clinical Orthopaedics and Related Research 12/1995; · 2.79 Impact Factor
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    ABSTRACT: This article attempts to outline the most current relevant literature regarding diagnosis, pathoanatomy, and treatment options for complex elbow instability. Specific attention is directed toward unique injury patterns, important biomechanical principles, and recent clinical outcome studies. Directions for future research are suggested.
    Hand Clinics 03/2008; 24(1):39-52. · 0.95 Impact Factor

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