Surgical treatment of elbow dislocations accompanied by coronoid fractures

Abstract

OBJECTIVES: We evaluated the results of surgical treatment for elbow dislocations accompanied by Regan-Morrey type 2-3 coronoid fractures. METHODS: Eight patients (6 males, 2 females; mean age 44 years; range 23 to 76 years) underwent surgical treatment for elbow dislocationsaccompanied by a coronoid fracture. Three patients had Regan-Morrey type 2, five patients had type 3 coronoid fractures. Accompanying injuries were Mason-Johnston type 4 radial head fractures (n=6), olecranon fractures (n=4), lateral humeral condyle fracture (n=1), and lateral (n=5) or medial (n=2) collateral ligament ruptures. Coronoid fractures were fixed with a plate, screw, or a cerclage wire in all the patients except for one patient who underwent coronoid excision. For radial head fractures, plate or screw and K-wire fixation was performed in two patients and radial head prosthesis was used in four patients. Olecranon fractures were fixed with a plate or AO tension band. Functional results were assessed using the Mayo elbowperformance score. The mean follow-up period was 22.6 months (range 1 to 65.5 months). RESULTS: Union was achieved in all the patients. At the latest assessments, the mean Mayo elbow performance score was 84.3 (range 50 to 100). All the patients expressed satisfaction with surgical treatment except for one patient who underwent coronoid excision. All the fixation materials used for olecranon fractures were removed after union due to implant-associated pain. Ulnar nerve transposition was required in two patients with fracturesinvolving the anteromedial facet of the coronoid process. Two patients developed heterotopic ossification that did not affect the range of motion of the elbow. CONCLUSION: Surgical treatment of elbow dislocations associated with Regan-Morrey type 2-3 coronoid fractures enables a concentric reduction of the elbow, stability, and early motion.