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Coronoid Fracture Workup

  • Author: Nirmal Tejwani, MD, MPA; Chief Editor: Harris Gellman, MD  more...
 
Updated: Nov 02, 2015
 

Imaging Studies

See the list below:

  • Radiographs of the elbow in the anteroposterior (AP), lateral, and, if required, oblique views should be obtained to ascertain clearly the extent of bony injury. Oblique views are especially important in minimally displaced fractures, because in a true lateral view of the elbow, the radial head overlaps the coronoid. To avoid this problem, Greenspan and Norman described the radiocapitellar view, in which the elbow is flexed to 90 º and placed flat on the table with the x-ray beam directed obliquely toward the shoulder.[25, 26] This separates the radial head from the coronoid. Regan and Morrey have classified coronoid fractures depending on the size of the fragment, as follows[8] :
    • Type 1: Avulsion of the tip of the coronoid process. (Linscheid et al do not believe this to be an avulsion, as the brachialis is attached to the base of the coronoid.[10] )
    • Type 2: Single or comminuted fragment involving less than 50% of the coronoid.
    • Type 3: Single or comminuted fragment involving more than 50% of the coronoid.
  • A CT scan may be useful in complex fracture dislocations to delineate the fracture patterns and for preoperative planning.[27, 28]
  • For MRI findings in elbows with a radial head fracture, see Kaas et al.[29]
 
 
Contributor Information and Disclosures
Author

Nirmal Tejwani, MD, MPA Professor of Orthopedic Surgery, New York University Hospital for Joint Diseases; Chief of Orthopedic Trauma, Bellevue Hospital

Nirmal Tejwani, MD, MPA is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Orthopaedic Trauma Association, AO Foundation

Disclosure: Received honoraria from Stryker for speaking and teaching; Received honoraria from Zimmer for speaking and teaching; Received royalty from Biomet for other.

Coauthor(s)

Mihir M Thacker, MBBS, MS(Orth), DNB(Orth), FCPS(Orth), D'Ortho Associate Professor of Orthopedic Surgery and Pediatrics, Jefferson Medical College of Thomas Jefferson University; Consulting Staff, Department of Pediatric Orthopedic Surgery, Alfred I duPont Hospital for Children; Orthopedic Oncologist, Helen F Graham Cancer Center and Christiana Care Health Services

Mihir M Thacker, MBBS, MS(Orth), DNB(Orth), FCPS(Orth), D'Ortho is a member of the following medical societies: Children's Oncology Group, Medical Council of India, Musculoskeletal Tumor Society, Pediatric Orthopaedic Society of North America, Limb Lengthening and Reconstruction Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Robert J Nowinski, DO Clinical Assistant Professor of Orthopaedic Surgery, Ohio State University College of Medicine and Public Health, Ohio University College of Osteopathic Medicine; Private Practice, Orthopedic and Neurological Consultants, Inc, Columbus, Ohio

Robert J Nowinski, DO is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, Ohio State Medical Association, Ohio Osteopathic Association, American College of Osteopathic Surgeons, American Osteopathic Association

Disclosure: Received grant/research funds from Tornier for other; Received honoraria from Tornier for speaking and teaching.

Chief Editor

Harris Gellman, MD Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami, Leonard M Miller School of Medicine, Clinical Professor, Surgery, Nova Southeastern School of Medicine

Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, Arkansas Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

Steven I Rabin, MD Clinical Associate Professor, Department of Orthopedic Surgery and Rehabilitation, Loyola University, Chicago Stritch School of Medicine; Medical Director, Orthopedic Surgery, Podiatry, Rheumatology, Sports Medicine, and Pain Management, Dreyer Medical Clinic; Chairman, Department of Surgery, Provena Mercy Medical Center

Steven I Rabin, MD is a member of the following medical societies: AO Foundation, American Academy of Orthopaedic Surgeons, American Fracture Association, Orthopaedic Trauma Association

Disclosure: Nothing to disclose.

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Elbow joint, anterior view.
Elbow joint, posterior view.
 
 
 
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