What is a Coronoid Fracture of the Elbow?
A coronoid fracture is a break in the coronoid process which is a bony prominence of the ulna bone in the elbow joint. This type of fracture occurs when a shearing force is applied over your elbow which usually leads to elbow dislocation.
Anatomy of the Coronoid Process
The coronoid process is a triangular bony eminence projecting forward from the upper and front part of the ulna, one of the forearm bones. It forms the greater sigmoid notch which articulates with the distal humerus or upper arm bone at the elbow joint. It also serves as a buttress, preventing posterior displacement of the ulna. The coronoid process is a site of attachment for the anterior bundle of the ulnar collateral ligament which connects the forearm and the upper arm bones.
Causes of a Coronoid Fracture of the Elbow
Coronoid fractures typically occur due to trauma; the contributing factors include:
- Exertional sports activities
- Accidental injury or trauma to the elbow
- Dislocation of elbow and forearm bones (proximal ends of radius and ulna)
- Hyper flexion or extension of the elbow
- Spontaneous twisting of the elbow
Classification of a Coronoid Fracture of the Elbow
Coronoid fractures are classified into the following types based on the injury’s location and fragments, such as:
Type 1 – The fracture involves the tip of the coronoid process.
Type 2 -The fracture involves 50% or less of the coronoid process.
Type 3 -The fracture involves more than 50% of the coronoid process.
Symptoms of a Coronoid Fracture of the Elbow
You might experience the following symptoms in the instance of a coronoid fracture of the elbow:
- Pain in the elbow or wrist and forearm
- Swelling and tenderness around the elbow
- Instability in the elbow
- Limited range of motion (flexion, extension and rotation) of the elbow and forearm
Diagnosis of a Coronoid Fracture of the Elbow
Your doctor performs a thorough physical examination looking for fracture signs and also notes your medical history. Further, imaging studies may be ordered to confirm the diagnosis such as:
- X ray
- CT Scan
Management of a Coronoid Fracture of the Elbow
Non Operative- Conservative methods are recommended in cases that are absent of any significant injuries or instability. These include:
- Immobilization with a splint for 2-3 weeks
- Pain relievers to reduce pain
- Anti-inflammatory medicines to treat inflammation
- Physical therapy to regain mobility and function
- Ice packs and hot compression
Operative- Surgical intervention may be required in the event of entrapped bony fragments or soft tissues within the elbow joint. The options include:
- Open and closed reduction
- Internal and external fixation
- Metal screws, plates, and k-wire fixation
Complications of a Coronoid Fracture of the Elbow
The possible complications include:
- Elbow stiffness
- Heterotopic ossification, which is formation of excess bone that limits mobility
- Post traumatic arthritis