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Coronoid Fracture Classification

 Type I Coronoid Fracture

Type I Coronoid Fracture, stable (avulsion of the tip of the coronoid process): sually related to posterolateral rotatory elbow subluxation. Treatment = early protected ROM.

Type I, unstable or associated radial head fracture. Treatment = ORIF; if fragment is large enough for fixation with a screw or k-wire it should be fixed. Any collateral ligament injury must be repaired as well.

Medial view of Proximal Ulna

  1. Trochlear notch
  2. Coronoid tip
  3. Anteromedial facet
  4. Sublime tubercle (18.4mm dorsal to coronoid tip; insertion site for anterior band of MCL)
  5. Base of coronoid
  6. Olecranon

 

Type II Coronoid Fracture

 

Type II Coronoid Fracture, stable( <50% of coronoid): Treatment = early protected ROM.

Type II, unstable or associated radial head fracture. Treatment = ORIF; if fragment is large enough for fixation with a screw or k-wire it should be fixed. Any collateral ligament injury must be repaired as well.

Medial view of Proximal Ulna

  1. Trochlear notch
  2. Coronoid tip
  3. Anteromedial facet
  4. Sublime tubercle (18.4mm dorsal to coronoid tip; insertion site for anterior band of MCL)
  5. Base of coronoid
  6. Olecranon
Type III Coronoid Fracture

Type III Coronoid Fracture (basal coronoid fracture): Treatment = ORIF usually via a posteromedial aproach. Often associated with olecranon fracture/dislocations. Associated injuries should be anatomically repaired as well.

Always consider hinged external fixation for severe injuries where joint stability is a concern post-operatively.

Medial view of Proximal Ulna

  1. Trochlear notch
  2. Coronoid tip
  3. Anteromedial facet
  4. Sublime tubercle (18.4mm dorsal to coronoid tip; insertion site for anterior band of MCL)
  5. Base of coronoid
  6. Olecranon
Anteromedial Facet Coronoid Fracture

 

Anteromedial Facet Coronoid Fracture, stable: Occur with varus posteromedial rotation during axial loading. Associated with LCL rupture and are usually unstable. Treatment = ensure joint is stable with stress radiographs, consider EUA. Early protected ROM if joint is confirmed to be stable.

Anteromedial facet fracture, unstable: Treatment = ORIF with concomitant LCL/radial head repair usually via a utilitarian posterior exposure with posteromedial coronoid exposure.

Always consider hinged external fixation for severe injuries where joint stability is a concern post-operatively.

Medial view of Proximal Ulna

  1. Trochlear notch
  2. Coronoid tip
  3. Anteromedial facet
  4. Sublime tubercle (18.4mm dorsal to coronoid tip; insertion site for anterior band of MCL)
  5. Base of coronoid
  6. Olecranon

Coronoid Review References