title: A novel approach for coronoid fractures.
abstract: The coronoid process serves as an important constraint that provides ulnohumeral joint stability. We describe a novel approach to coronoid fractures that minimizes surgical dissection, without compromising fracture visualization. We present the case of a 65-year-old woman who sustained an anteromedial facet fracture of the coronoid process. The elbow demonstrated intractable posteromedial instability and the inability to maintain reduction even up to 90 degrees. This report describes a surgical approach to the coronoid process that minimizes extensive soft tissue dissection. It is a variation of the previously described approach by Taylor and Scham, although it can achieve a similar exposure without elevation of the entirety of the flexor-pronator mass. Our approach involves a limited skin incision, followed by elevation of enough of the flexor-pronator mass such that adequate visualization of the posterior medial collateral ligament (which was repaired), anteromedial facet, and the fractured fragment of coronoid were achieved. Moreover, this approach enables the course of the ulnar nerve to remain unaltered.
authors.affiliation: Department of Orthopedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, NY.
authors.forename: Dave R
authors.initials: DR
authors.lastname: Shukla
authors.forename: Steven M
authors.initials: SM
authors.lastname: Koehler
authors.forename: Sara M
authors.initials: SM
authors.lastname: Guerra
authors.forename: Michael R
authors.initials: MR
authors.lastname: Hausman
mesh_terms: D000368:Aged; D004551:Elbow Joint / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability; D019637:Orthopedic Procedures / Q000379:methods*; D011859:Radiography; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D000092464:Elbow Injuries