Coronoid fractures and elbow instability, general review and clinical presentation

Abstract

Elbow joint has three articulations: (1) ulnatrochlear, (2) radiocapitellar, and (3) radioulnar. The olecranon and coronoid fossa of distal humerus separate medial and lateral columns of the distal humerus. Medial column ends with spool-shaped trochlea, and lateral column ends with spherical capitellum. The irregularity of elbow joint in anatomic means is not an impediment for the joint to be congruent. Congruity of the ulna humeral articulation is the mainstay of the osseous stability and mobility in flexion and extension plane. Fracture dislocation of the elbow is a well-defined injury, but it is difficult to achieve satisfactory good results due to some pitfalls. Coronoid process, radial head and neck or both can be fractured. Treatment decision of uncomplicated elbow fractures depends on the stability after reduction. Understanding the anatomy and the biomechanics of elbow is crucial to diagnose and treat elbow instability. Treatment of fracture dislocation of the elbow is a challenge for the orthopedic surgeon. Here, we emphasized the anatomic and biomechanical knowledge about importance of the recognition, identification, and treatment of coronoid process in restoring the sufficient stability of the elbow to allow early mobilization with an excellent functional outcome.