O'Driscoll classification of coronoid process fractures

Last revised by Ashesh Ishwarlal Ranchod on 20 May 2023

The O'Driscoll classification system of coronoid process fractures distinguishes three types of coronoid process fractures of the ulna, and this classification system is useful when assessing further treatment options 1-4.

  • type I: transverse coronoid tip fractures, which affect one-third of the process
  • type II: injuries involve the anteromedial facet, with subtypes varying according to the fracture's location along the facet and the sublime tubercle's degree of involvement
    • subtype 1: involvement of only the anteromedial portion
    • subtype 2: involvement of anteromedial portion and tip
    • subtype 3: involvement of anteromedial portion, tip, and >50% of sublime tubercle
  • type III: involve the coronoid process base, with disruption of more than 50% of the coronoid body

Small type I injuries can be treated non-operatively if stability is maintained; however, if these fractures are associated with instability, it requires surgical repair 1-4. In general coronoid process fractures, type II and III require surgical repair to maintain elbow stability, and the surgical approach varies by fracture type 1-4.

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Cases and figures

  • Case 1: type II
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  • Case 2: type III
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  • Case 3: type I
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  • Case 4: type III
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  • Case 5: type I
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  • Case 6: type I
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  • Case 7: type III
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