Non surgically managed anteromedial coronoid fractures in posteromedial rotatory instability: three cases with 2 years follow-up

Moon, Jun Gyu; Bither, Nitin; Jeon, Young Jin; Oh, Sung Mok

doi:10.1007/s00402-013-1846-y

Cited by 36 publications

(9 citation statements)

References 7 publications

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“…This is because such injuries regularly involve the lateral collateral ligament complex as well as the posteromedial ligament 13 . In this combination, these injuries were proven to be significantly more unstable, promoting a posteromedial rotatory instability of the elbow, which is, again, thought to lead to early post-traumatic arthrosis 3 , 4 , 13 , 14 , 15 , 16 , 17 . It is well known that the distal anterior greater sigmoid notch is continuous with the articular surface of the proximal radioulnar joint (PRUJ).…”

Section: Discussionmentioning

confidence: 99%

Injuries to the Coronoid Process of the Ulna with Involvement of the Lesser Sigmoid Notch

et al. 2020

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Introduction This study aimed to describe the involvement of the lesser sigmoid notch in fractures to the coronoid process. We hypothesized that injuries to the lateral aspect of the coronoid process regularly involve the annular ligament insertion at the anterior lesser sigmoid notch. Material and Methods Patients treated for a coronoid process fracture at our institution between 06/2011 and 07/2018 were included. We excluded patients < 18 years, patients with arthritic changes or previous operative treatment to the elbow, and patients with concomitant injuries to the proximal ulna. In patients with involvement of the lesser sigmoid notch, the coronoid height and fragment size (anteroposterior, mediolateral, and craniocaudal) were measured. Results Seventy-two patients (mean age: 47 years ± 17.6) could be included in the study. Twenty-one patients (29.2%) had a fracture involving the lateral sigmoid notch. The mean anteroposterior fragment length was 7 ± 1.6 mm. The fragment affected a mean of 43 ± 10.8% of the coronoid height. The mean mediolateral size of the fragment was 10 ± 5.0 mm, and the mean cranio-caudal size was 7 ± 2.7 mm. Conclusion Coronoid fractures regularly include the lesser sigmoid notch. These injuries possibly affect the anterior annular ligament insertion which is important for the stability of the proximal radioulnar joint and varus stability of the elbow.

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Section: Discussionmentioning

confidence: 99%

Injuries to the Coronoid Process of the Ulna with Involvement of the Lesser Sigmoid Notch

et al. 2020

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“…24 In a selected cohort of patients with minimally displaced anteromedial facet fractures adequate non surgical treatment can provide a stable elbow with good function. 25,26 Type 3 fractures are best managed with a plate fixation (Fig. 10).…”

Section: Operativementioning

confidence: 99%

Proximal ulna fractures in adults: A review of diagnosis and management

Masood

Qulaghassi

Grewal

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Proximal ulna fractures are relatively common upper limb injuries, which may represent fragility fractures or result from high-energy trauma. These include fractures of the olecranon, coronoid and associated radial head dislocations. A wide variety of treatment options are available for the management of these injuries that makes the selection of most appropriate treatment difficult. We aim to provide a brief overview of the treatment options for such injuries.

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“…There were no subtype 1 fractures in our study, but Pollock et al [26] have shown that these fractures may be treated non-operatively if the fragment size remains small (<5 mm) and the MCL is intact. Caution is advised when managing subtype 3 fractures, even though we successfully treated one patient with a minimally displaced subtype 3 fracture, similar to a small series by Moon et al [27]. Surgical fixation is recommended for the majority of patients with this injury since the elbow joint lacks stability from the lateral collateral ligament and the loss of the medial buttressing effect of an intact coronoid.…”

Section: Anteromedial Coronoid Fracturesmentioning

confidence: 90%

Treatment of complex elbow fracture-dislocations

Chan

King

Faber

2016

Curr Rev Musculoskelet Med

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Successful management of complex elbow fracture-dislocations requires, in part, recognition of the overall injury pattern, which can aid in the identification of concomitant bony and soft tissue injuries. Trans-olecranon fracture-dislocations are best treated surgically with stable anatomic restoration of the trochlear notch. Terrible triad elbow injuries are believed to be caused by a valgus posterolateral force. Although select terrible triad injuries can be managed non-operatively, the majority of injuries are treated with stable surgical repair to allow early elbow motion. Unlike terrible triads, varus posteromedial forces are theorized to cause anteromedial coronoid fractures. These are usually associated with LCL disruptions, but do not have concomitant MCL or radial head injuries. A subset of anteromedial coronoid fractures can also be managed non-operatively. Internal fixation is recommended for injuries associated with large fracture fragments or elbow instability preventing early motion.

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Non surgically managed anteromedial coronoid fractures in posteromedial rotatory instability: three cases with 2 years follow-up

Cited by 36 publications

References 7 publications

Injuries to the Coronoid Process of the Ulna with Involvement of the Lesser Sigmoid Notch

Injuries to the Coronoid Process of the Ulna with Involvement of the Lesser Sigmoid Notch

Proximal ulna fractures in adults: A review of diagnosis and management

Treatment of complex elbow fracture-dislocations

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