title: Arthroscopic fixation of coronoid process fractures through coronoid tunnelling and capsular plication.
abstract: OBJECTIVE
  the purpose of this study is to describe a new arthroscopic technique for reduction and fixation of coronoid process fractures (CPFs) and report clinical and functional results in 4 patients after a 24-month follow-up.
  
  
  METHODS
  four patients underwent arthroscopic reduction and fixation of isolated CPFs (acute or non-unions, type I or type II according to the Regan-Morrey classification) performed using a new technique based on coronoid tunnelling and capsular plication. The patients were evaluated 6, 12 and 24 months after surgery, using the Disability of the Arm, Shoulder and Hand scale (DASH), the Mayo Elbow Performance Index (MEPI), and a visual analog scale (VAS); elbow range of motion (ROM) and joint stability were also evaluated and the rate of complications was reported.
  
  
  RESULTS
  all 4 patients completed the follow-up. At 6, 12 and 24 months, respectively, they recorded mean DASH scores of 22, 14 and 7, mean MEPI scores of 74, 82 and 94, and mean VAS scores of 4, 2 and 1. The mean ROM increased in all directions (at 6, 12 and 24 months, respectively: flexion: 112°, 125°, 144°; extension: 3°, 5°, 6°; pronation: 76°, 84°, 91°; supination: 78°, 82°, 86°). No signs of instability were observed and no complications were reported.
  
  
  CONCLUSIONS
  the new all-arthroscopic coronoid tunnelling and capsular plication technique here proposed can restore elbow function, ROM and stability and allows anatomical reconstruction of the joint after type I or type II CPFs. If performed by an experienced arthroscopist, it is a valid alternative to open reduction and external fixation.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Università degli Studi di Milano, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Arrigoni
authors.affiliation: Università degli Studi di Milano, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: D'Ambrosi
authors.affiliation: Università degli Studi di Milano, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Cucchi
authors.affiliation: Ospedale San Jacopo, Pistoia, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Nicoletti
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Guerra
keywords: bone tunnelling; capsular plication; coronoid; elbow arthroscopy; fracture