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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 5, 632-635.
doi: 10.1302/0301-620X.91B5.21755  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Management and outcome of 103 acute fractures of the coronoid process of the ulna

J. E. Adams, MD, Assistant Professor of Orthopaedic Surgery1; T. L. Hoskin, MS, Statistician2; B. F. Morrey, MD, John Posy Krehbiel Professor of Orthopaedic Surgery3; and S. P. Steinmann, MD, Professor of Orthopaedic Surgery3

1 Department of Orthopaedic Surgery University of Minnesota, 2450 Riverside Avenue, R 200, Minneapolis, Minnesota 55454, USA.
2 Department of Biostatistics
3 Department of Orthopaedic Surgery Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.

Correspondence should be sent to Professor S. P. Steinmann; e-mail: Steinmann.Scott{at}Mayo.edu

A series of 103 acute fractures of the coronoid process of the ulna in 101 patients was reviewed to determine their frequency. The Regan-Morrey classification, treatment, associated injuries, course and outcomes were evaluated. Of the 103 fractures, 34 were type IA, 17 type IB, ten type IIA, 19 type IIB, ten type IIIA and 13 type IIIB. A total of 44 type-I fractures (86%) were treated conservatively, while 22 type-II (76%) and all type-III fractures were managed by operation.

At follow-up at a mean of 3.4 years (1 to 8.9) the range of movement differed significantly between the types of fracture (p = 0.002). Patients with associated injuries had a lower Mayo elbow performance score (p = 0.03), less extension (p = 0.03), more pain (p = 0.007) and less pronosupination (p = 0.004), than those without associated injuries. The presence of a fracture of the radial head had the greatest effect on outcome. An improvement in outcome relative to that of a previous series was noted, perhaps because of more aggressive management and early mobilisation. While not providing complete information about the true details of a fracture and its nature, the Regan-Morrey classification is useful as a broad index of severity and prognosis.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General