Treatment of the coronoid process fractures with anteromedial approach: a case report

This study aimed to explore the clinical effect of the coronoid process fractures with anteromedial approach. 18 cases of coronoid process fractures treated with the anteromedial approach were enrolled. Causes of injury included traffic injuries in 3 cases and fall on the ground in 15 cases. There were 6 cases of type I, 10 cases of type II, and 2 cases of type III according to the O'Driscoll classification. The time from injury to operation was 2-10 days (mean, 3.9 days). Fractures were fixed by using mini-plate or screws. All cases were followed-up for 12-24 months (average 14.9 months). The bony union time was 8-14 weeks with an average of 10.6 weeks. The mean flexion at last follow-up was 122 degrees (range, 90 degrees-140 degrees), the mean extension loss was 20 degrees (range, 0 degrees-50 degrees), and the mean pronation was 67 degrees (range, 22 degrees-90 degrees), while the mean supination was 61 degrees (range, 30 degrees-88 degrees). Elbows were stable in the flexion-extension and varus-valgus in all cases. According to the MEPS elbow performance score, results were excellent in 14 cases, good in 3 cases and fair in 1 case. According to the Broberg and Morrey elbow performance score, results were excellent in 9 cases, good in 4 cases, and fair in 1 case. In conclusion, the anteromedial approach facilitates the reduction and fixation of the coronoid process fractures and has advantages of clear exposure, convenient placement of internal fixation, small invasion and good clinical results.