Unstable elbow dislocation with coronoid process fracture associated with distal radius fracture: a case report and review of the literature

We present a case of distal radial shaft fracture associated with elbow dislocation and coronoid process fracture. The associated coronoid fracture was initially missed. Closed reduction of the elbow and open reduction with internal fixation of the radial fracture were achieved immediately after admission. Radiographic control 3 days later showed that the elbow was redislocated into the cast. A careful reevaluation of the radiographs disclosed the coronoid fracture. An anterior approach of the elbow permits to reduce and fix the coronoid process. In addition, a hinged external fixator was applied to maintain concentric elbow reduction, and to protect the coronoid fracture fixation and the capsulo-ligamentous healing, while early elbow motion was started. The final result at 10-year follow-up was excellent both clinically and radiologically. According to our knowledge, a similar presentation of distal radial shaft fracture with ipsilateral unstable complex elbow dislocation and fracture of the coronoid process has never been described in the previous literature.