title: Prosthetic replacement for coronoid deficiency: report of three cases.
abstract: BACKGROUND
  Persistent elbow instability associated with coronoid deficiency is a difficult condition to treat. Several surgical techniques have been described for coronoid reconstruction, but the resulting outcomes have been unpredictable. We hypothesized that a coronoid prosthesis could restore elbow stability.
  
  
  METHODS
  A nonanatomically shaped metallic coronoid prosthesis was custom designed for each of 3 patients. Each had a chronic fracture-subluxation with persistent instability, deficiencies of the coronoid, and compromise of the radial head. Each patient had undergone 2 to 4 prior failed operations.
  
  
  RESULTS
  At a mean follow-up of 11 years (range, 10-12), 2 of the 3 patients were completely pain free; the third had a visual analog scale pain score not greater than 3/10. All 3 maintained a stable joint, although a functional range of motion was not able to be maintained in any. Two patients rated themselves "improved" and 1 patient rated himself "almost normal" on the Summary Outcome Determination scale. All radiographic follow-up showed the coronoid prosthesis in proper position without loosening.
  
  
  CONCLUSIONS
  Prosthetic replacement of the coronoid appears successful in restoring stability in chronically unstable elbows with coronoid deficiency.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopedics and Traumatology, University of Turin Medical School, Turin, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Bellato
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. Electronic address: odriscoll.shawn@mayo.edu.
authors.forename: Shawn W
authors.initials: SW
authors.lastname: O'Driscoll
mesh_terms: D000328:Adult; D004551:Elbow Joint / Q000601:surgery*; D005544:Forecasting; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Coronoid prosthesis; coronoid; coronoid deficiency; elbow; elbow instability; unstable elbow