Coronoid process fracture

Case contributed by Dr Antonio Rodrigues de Aguiar Neto

Presentation

This patient admitted to the ER reports a fall from standing height, presenting pain in his right elbow.

Patient Data

Age: 45 years
Gender: Male
ct

CT images demonstrate a fracture extending through the anteromedial facet of the coronoid process, indicating an increased risk for elbow instability.

No other fractures. The alignment of the elbow is intact.

Elbow joint effusion.

Impression: The CT findings are consistent with an O'Driscoll type II fracture

x_ray

AP and lateral radiographs after internal fixation of the coronoid process fracture combined with repair of the anterior band of the medial ulnar collateral ligament, showing anatomical reduction maintained by one metal plate and three screws.

Impression: Surgical osteosynthesis of coronoid process fracture. 

Case Discussion

Fractures of the ulna's coronoid process are uncommon, whether associated with the elbow dislocation or isolated fractures limited only to the coronoid process 1-3. The O'Driscoll classification system distinguishes these fractures into three types 1,2,4. Type I transverse coronoid tip fractures, type II injuries involve the anteromedial facet and type III fractures through the coronoid process's base 1,2,4. Radiologists should describe these fractures using the same classification systems adopted by orthopedic surgeons 2,5.

This case is a typical example of an O'Driscoll type II fracture of the ulna's coronoid process, requiring surgery with internal fixation.

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