Transverse Coronoid Fracture: When Does It Have to Be Fixed?

Hartzler, Robert U.; Llusá-Pérez, Manuel; Steinmann, Scott P.; Morrey, B.F.; Sánchez-Sotelo, Joaquín

doi:10.1007/s11999-014-3477-1

Cited by 46 publications

(23 citation statements)

References 10 publications

(10 reference statements)

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“…Saunders claims that injury to it causes posterolateral instability. Dunning argues that only injuries to both the LCUL and the RCL (radial collateral ligament) lead to posterolateral instability [19–23]. We believe in achieving good lateral ligament complex healing with HEF protection.…”

Section: Discussionmentioning

confidence: 98%

Hinged external fixation for Regan–Morrey type I and II fractures and fracture-dislocations

Castelli

D’Amico²,

Combi

et al. 2016

J Orthopaed Traumatol

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Elbow fracture-dislocation is always demanding to manage due to the considerable soft-tissue swelling or damage involved, which can make an early open approach and ligamentous reconstruction impossible. The purpose of this study was to evaluate the role of elbow hinged external fixation (HEF) as a definitive treatment in patients with elbow dislocations associated with Regan–Morrey (R-M) type I and II coronoid fractures and soft-tissue damage. We treated 11 patients between 2010 and 2012 with HEF. Instability tests and standard X-ray examinations were performed before surgery and 1–3 to 3–6 months after surgery, respectively. All patients underwent a preoperative CT scan. Outcomes were assessed with a functional assessment scale (Mayo Elbow Performance Score, MEPS) that included 4 parameters: pain, ROM, stability, and function. The results were good or excellent in all 11 patients, and no patient complained of residual instability. Radiographic examination showed bone metaplasia involving the anterior and medial sides of the joint in 5 patients. HEF presented several advantages: it improves elbow stability and it avoids long and demanding surgery in particular in cases with large soft tissue damage. We therefore consider elbow HEF to be a viable option for treating R-M type I and II fracture-dislocations.

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Section: Discussionmentioning

confidence: 98%

Hinged external fixation for Regan–Morrey type I and II fractures and fracture-dislocations

Castelli

D’Amico²,

Combi

et al. 2016

J Orthopaed Traumatol

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“…The kinematic pattern of the elbow was recorded and analyzed in the manner described in the first part of this study [8]. The detailed protocol is described in that work.…”

Section: Methodsmentioning

confidence: 99%

“…To summarize, (1) six cadaver specimens underwent simulated terrible triad injuries with a transverse fracture involving 50% of the coronoid, lateral collateral release, and resection of the radial head. (2) Standard Cartesian coordinate systems for the humerus and ulna were defined by the digitization of anatomic landmarks [8,17]. Euler rotations were used to define ulnohumeral flexion-extension angle (first Euler rotation), varus-valgus angle (second Euler rotation), and internal-external rotation angle (third Euler rotation).…”

Section: Methodsmentioning

confidence: 99%

“…The elbow was moved passively by hand by a single investigator (MLP) from full extension to full flexion with the forearm maintained in neutral pronation-supination position by holding the specimen gently at the wrist. 3The specimens were then stabilized by 3.5-mm lag screw fixation of the coronoid and restoration of lateral collateral ligament integrity via fixation of the lateral epicondylar osteotomy, as previously described [8]. The effectiveness of these methods to restore stability of the elbow was documented [8].…”

Section: Methodsmentioning

confidence: 99%

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Radial Head Reconstruction in Elbow Fracture-Dislocation: Monopolar or Bipolar Prosthesis?

Hartzler¹,

Morrey

Steinmann

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…6 What is the best approach to get to specific patterns of coronoid fracture? What are the best options to fix or re-construct the coronoid?…”

Section: Management Of Individual Structuresmentioning

confidence: 99%

Complex elbow instability: surgical management of elbow fracture dislocations

Sánchez-Sotelo

Morrey

2016

EFORT Open Reviews

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There are three main patterns of complex elbow instability: posterolateral (terrible triad), varus posteromedial (anteromedial coronoid fracture with lateral collateral ligament complex disruption), and trans-olecranon fracture dislocations.Radial head fractures, in the setting of complex elbow instability, often require internal fixation or arthroplasty; the outcome of radial head replacement is dictated by adequate selection of the head diameter, correct restoration of radial length, and proper alignment and tracking.Small coronoid fractures can be ignored. Larger coronoid fractures, especially those involving the anteromedial facet, require fixation or graft reconstruction, particularly in the presence of incongruity.The lateral collateral ligament complex should be repaired whenever disrupted. Medial collateral ligament disruptions seem to heal reliably without surgical repair provided all other involved structures are addressed.The most common mistakes in the management of trans-olecranon fracture dislocations are suboptimal fixation, lack of fixation of coronoid fragments, and lack of restoration of the natural dorsal angulation of the ulna.Cite this article: Sanchez-Sotelo J, Morrey M. Complex elbow instability. EFORT Open Rev 2016;1:183-190.

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Transverse Coronoid Fracture: When Does It Have to Be Fixed?

Cited by 46 publications

References 10 publications

Hinged external fixation for Regan–Morrey type I and II fractures and fracture-dislocations

Hinged external fixation for Regan–Morrey type I and II fractures and fracture-dislocations

Radial Head Reconstruction in Elbow Fracture-Dislocation: Monopolar or Bipolar Prosthesis?

Complex elbow instability: surgical management of elbow fracture dislocations

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