Coronoid Fractures and Varus Posteromedial Rotatory Instability

Abstract

Coronoid fractures are associated with elbow fracture-dislocations. Fractures involving the anteromedial facet of the coronoid often are associated with a posteromedial rotational instability pattern which requires careful management to avoid persistent and often subtle instability. Although some anteromedial coronoid fractures may be treated nonoperatively, internal fixation through a medial approach is indicated in most cases. Without a universally accepted treatment algorithm, surgeons should consider the risk of persistent instability when approaching this injury pattern. Fracture morphology, fragment size, and joint congruity, as determined by computed tomography imaging and physical examination, inform clinical decision making.