Midterm results of 19 fractures of the coronoid process of the ulna and concomitant injuries

Background. Fractures of the coronoid process are rare but difficult to treat. In a retrospective evaluation of a consecutive case series at a regional trauma centre, midterm results and prognostic factors of these injuries were evaluated. Materials and methods. Over a period of 5 years (2004-2009) data sets of 26 patients were available. Of these, 18 patients (69 %) were available for an interview and examination at an average of 34 months (SD 20 months) after trauma. Results were statistically evaluated. Results. The mean age was 56 years (SD 14 years), 14 patients were female, and 13 cases each involved the right or left elbow, respectively. Fracture types according to Regan and Morrey were types I (n = 10), II (n = 5) and III (n = 11). Concomitant injuries were elbow dislocation in 19 cases, radial head fractures in 18 cases, proximal ulnar fractures in 5 cas-es and fractures of the olecranon in 2 cases. A mean range of movement (ROM) of 109 degrees (SD 17) was determined for extension/flexion and 154 degrees (SD 37) for pronation/supination. Of the 19 patients 11 (58 %) reported having a stable joint function. The mean Mayo elbow performance score (MEPS) was determined with 78 (SD 16; range 50-100) points. Conclusions. A surgical treatment of concomitant ligamentous injuries after fracture luxation of the elbow joint cannot be justified according to these data. A stable bony reconstruction has prognostic value. A complete excision of the radia l head weakens joint stability and was treated statistically more often with an external fixator.