Internal fixation for the treatment of anteromedial facet fracture of the coronoid process of ulna

Objective:To investigate the effect of operative treatment for anteromedial facet fracture of the coronoid process of ulna,and to study its surgical exposures and fixation techniques. Methods:From March 2005 to March 2010,18 patients with anteromedial facet fracture of the coronoid process of ulna were treated with open reduction and internal fixation. There were 12 males and 6 females with an average age of 37.8 years. A single midline posterior incision was used to expose the entire elbow joint. After elevating the full-thickness skin flaps,a lateral incision was made to expose and repair the lateral collateral ligament. Three intervals in the flexor-pronator musculature were used to gain access to the coronoid,depending on the size of the fracture fragment and the planned fixation technique. Fractures were fixed by using mini-plate or with screws. The therapeutic effects were evaluated by Mayo Elbow Performance Score(MEPS) and system of Broberg Morrey. Results:Seventeen patients were followed up,no patient complained pain and elbow unstable at a mean follow-up period of 38 months(1 to 6 years). The fractures were clinically healed at an average time of 11.6 weeks(ranged from 8 to 16 weeks). The average MEPS was 95.4±4.6 (ranged,82 to 100). The average functional rating of system of Broberg Morrey was 92.3±5.8 (ranged,75 to 100). Conclusion:Open reduction and internal fixation is effective to reach anatomical reduction and strong fixation for the treatment of anteromedial facet fracture of the coronoid process of ulna.