Role of the coronoid process in varus osteoarticular stability of the elbow

The role of the coronoid process in varus osteoarticular stability of the elbow was investigated in 10 cadaveric elbows. Testing was performed at multiple flexion angles after incremental removal of the coronoid. At each flexion angle, removal of more than 50% of the coronoid produced a statistically significant decrease in the load resisting varus displacement compared with all lesser resection levels (P < .003). There was a trend for decreasing load after removal of 50% of the coronoid. The mean decrease in load across all flexion angles was 70.1%, 50.4%, and 75.4% after removal of 50%, 75%, and 100% of the coronoid, respectively. Resistance to varus displacement tended to decrease more as a percent of control at lower flexion angles than at higher flexion angles after removal of more than 50% of the coronoid. The coronoid process was found to be a key varus stabilizer in the elbow and may contribute more to elbow stability in extension than in flexion.