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Coronoid Fracture Case

 Type III coronoid fracture xray Reagan and Morrey Type III coronoid fracture sustained in a slip and fall. No radiographic evidence of dislocation. Lateral view at presentation 1week after injury shown
Type III coronoid fracture xray A/P injury view.

Examination revealed postive lateral pivot shift sign and posterolateral rotary drawer test indicative of posterolateral rotary instability.

elbow posterior approach A utilitarian posterior approach was made. Posteromedial exposure diagram is shown.
  • Incision from 6cm proximal to olecranon to 6cm distal to olecranon. Curved around medial border of olecranon to avoid painful scar.
  • Medial and lateral skin flaps were raised. The lateral collateral ligament was avulsed from the lateral epicondyle. It was repaired with #2 ethibond suture through bone tunnels.
  • Ulnar nerve was identified and transposed anterior to the medial epicondyle.
  • Flexor carpi ulnaris incised in line with its origin, leaving a fascial cuff for later repair. FCU was subperiosteally elevated exposing anterior band of medial collateral ligament and the coronoid.
  1. Common Flexor orgin
  2. Transposed ulnar nerve
  3. Medial epicondyle
  4. Anterior band of radial collateral ligament
  5. Triceps tendon
  6. Olecranon
  7. Coronoid
  8. Reflected FCU origin
Type III coronoid fracture orif The fracture was reduced and fixed with 0.062 k-wires and buttress with a Mayo Clinic Congruent Coronoid plate.

Post-operative lateral view.

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