title: Quantitative 3-dimensional computed tomography measurements of coronoid fractures.
abstract: OBJECTIVE
  Using quantitative 3-dimensional computed tomography (Q3DCT) modeling, we tested the null hypothesis that there was no difference in fracture fragment volume, articular surface involvement, and number of fracture fragments between coronoid fracture types and patterns of traumatic elbow instability.
  
  
  METHODS
  We studied 82 patients with a computed tomography scan of a coronoid fracture using Q3DCT modeling. Fracture fragments were identified and fragment volume and articular surface involvement were measured within fracture types and injury patterns. Kruskal-Wallis test was used to evaluate the Q3DCT data of the coronoid fractures.
  
  
  RESULTS
  Fractures of the coronoid tip (n = 45) were less fragmented and had the smallest fragment volume and articular surface area involvement compared with anteromedial facet fractures (n = 20) and base fractures (n = 17). Anteromedial facet and base fractures were more fragmented than tip fractures, and base fractures had the largest fragment volume and articular surface area involvement compared with tip and anteromedial facet fractures. We found similar differences between fracture types described by Regan and Morrey. Furthermore, fractures associated with terrible triad fracture dislocation (n = 42) had the smallest fragment volume, and fractures associated with olecranon fracture dislocations (n = 17) had the largest fragment volume and articular surface area involvement compared with the other injury patterns.
  
  
  CONCLUSIONS
  Analyzing fractures of the coronoid using Q3DCT modeling demonstrated that fracture fragment characteristics differ significantly between fracture types and injury patterns. Detailed knowledge of fracture characteristics and their association with specific patterns of traumatic elbow instability may assist decision making and preoperative planning.
  
  
  CONCLUSIONS
  Quantitative 3DCT modeling can provide a more detailed understanding of fracture morphology, which might guide decision making and implant development.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA; Orthotrauma Research Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Jos J
authors.initials: JJ
authors.lastname: Mellema
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA; Orthotrauma Research Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Stein J
authors.initials: SJ
authors.lastname: Janssen
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA; Orthotrauma Research Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Thierry G
authors.initials: TG
authors.lastname: Guitton
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA; Orthotrauma Research Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: dring@partners.org.
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D015601:Injury Severity Score; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D015588:Observer Variation; D011885:Radius Fractures / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014458:Ulna Fractures / Q000000981:diagnostic imaging; D055815:Young Adult; D000092464:Elbow Injuries
keywords: 3-dimensional; Coronoid; computed tomography; fracture; morphology