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Coronoid Process Fracture

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61. Mandible Fractures in Children

to muscle spasm and pain. However, restriction of jaw motion may be secondary to a displaced zygomatic fracture impinging on the coronoid process of the mandible. Intraoral examination may reveal lacerations or hematomas. If bone is exposed through an intraoral or cutaneous laceration, antibiotics are indicated. Penicillin covers most mouth flora. A first-generation cephalosporin covers most skin flora. Examination of teeth for injury also is important. Rapid treatment of dental injuries, especially (...) Mandible Fractures in Children Pediatric Mandible Fractures: Background, Epidemiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODcyNjYyLW92ZXJ2aWV3 processing > Pediatric Mandible Fractures Updated

2014 eMedicine Surgery

62. Facial Trauma, Zygomatic Complex Fractures

patients. Trismus Trismus is also a common finding (45%), particularly after a fracture involving the zygomatic arch. It results from impingement upon the coronoid process of the mandible by a depressed zygomatic arch. This may indicate a need for elevation of the depressed arch, accurate reduction, and fixation. If new bone has formed in the space below the zygomatic arch and restricts the movement of the mandible, an intraoral approach for coronoidectomy may be required to permit mandibular movement (...) Facial Trauma, Zygomatic Complex Fractures Zygomatic Complex Facial Fractures: History, Anatomy, Classification Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI4NDE0Mi1vdmVydmlldw== processing > Zygomatic

2014 eMedicine Surgery

63. Facial Trauma, Mandibular Fractures

%) of the mandible. The symphyses account for 17% of mandibular fractures, whereas fractures of the ramus (4%) and coronoid process (1%) have lower occurrence rates. In automobile accidents, the condylar region was the most common fractured site. In motorcycle accidents, the symphysis was fractured most often. When assault was the cause, the angle demonstrated the highest incidence of fracture. [ ] A literature review by Giovacchini et al indicated that the presence of a mandibular third molar doubles the risk (...) to the posterosuperior attachment of the masseter muscle (usually distal to the third molar) Right mandibular body fracture. Left mandibular angle fracture going through tooth #17. Ramus - Bounded by the superior aspect of the angle to two lines forming an apex at the sigmoid notch Right mandibular ramus and left mandibular parasymphysis fractures. Condylar process - Area of the condylar process superior to the ramus region Right mandibular condylar fracture. Coronoid process - Includes the coronoid process

2014 eMedicine Surgery

64. Olecranon Fractures (Treatment)

for noncomminuted fractures. The goal is to convert the extensor force of the triceps to a dynamic compression force along the articular surface. Tension band wiring is indicated for displaced fractures proximal to the coronoid process that are not at risk of compressing the olecranon fossa. Tension band wiring is contraindicated if the articular surface is comminuted and unstable. [ , , , , ] Takada et al have described a minimally invasive technique for tension band wiring. [ ] The fracture is usually reduced (...) . [ ] The challenges associated with appropriate technical placement of the hardware are underestimated. Despite good functional results, Schneider et al found technical imperfections to be common. [ ] Previous Next: Plate Fixation Plate fixation is most commonly recommended for comminuted fractures for which tension band wire fixation is not feasible. It also is indicated for fractures that involve the coronoid process or extend distal to the coronoid process, including those extending into the shaft

2014 eMedicine Surgery

65. Supracondylar Humerus Fractures (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI2OTU3Ni10cmVhdG1lbnQ= processing > Supracondylar Humerus Fractures Treatment & Management Updated: Feb 15, 2017 Author: Jiun-Lih Jerry Lin, MBBS, MS(Orth); Chief Editor: Jeffrey D Thomson, MD Share Email Print Feedback Close Sections Sections Supracondylar Humerus Fractures Treatment Approach Considerations The main goals of surgical treatment of supracondylar humerus fractures are as follows: Prevent further injury Restore normal anatomy Provide an optimal environment for healing If these goals are met (...) to be sacrificed for later anterior transposition. Nerve then is carefully retracted and protected with vascular tape. The olecranon is isolated, and a small incision is made in the medial or lateral capsule for passage of a probe into the trochlea to palpate the level of the coronoid process. The apex of the chevron osteotomy then is planned 3-5 mm proximal to the coronoid, with the apex directed distally. (This also will correlate with a point just proximal to the radioulnar articulation.) Because the author

2014 eMedicine Surgery

66. Distal Humerus Fractures (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIzOTUxNS10cmVhdG1lbnQ= processing > Distal Humerus Fractures Treatment & Management Updated: Oct 23, 2017 Author: Edward Yian, MD; Chief Editor: Harris Gellman, MD Share Email Print Feedback Close Sections Sections Distal Humerus Fractures Treatment Approach Considerations The decision to offer operative intervention for distal humerus fractures is based on many factors, including fracture type, intra-articular involvement, fragment displacement, bone quality, joint stability, and soft-tissue quality and coverage (...) , it appears that TEA may help elderly patients with severe bone loss and comminution. Elbow hemiarthroplasty (EHA) has also been described as a possible alternative to TEA in older patients. [ , ] Next: Nonoperative Therapy Nonoperative treatment depends on the fracture type. Casting and immobilization can be used for nondisplaced fractures, particularly with medial, lateral, and supracondylar process fractures (extra-articular and extracapsular). Medial epicondylar fractures can be immobilized for 7 days

2014 eMedicine Surgery

67. Distal Humerus Fractures (Overview)

Distal Humerus Fractures (Overview) Distal Humerus Fractures: Background, Anatomy, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIzOTUxNS1vdmVydmlldw== processing > Distal Humerus Fractures Updated (...) : Oct 23, 2017 Author: Edward Yian, MD; Chief Editor: Harris Gellman, MD Share Email Print Feedback Close Sections Sections Distal Humerus Fractures Overview Background The elbow joint coordinates movements of the upper extremity, facilitating the execution of activities of daily living in areas such as hygiene, dressing, and cooking. When the distal humerus is injured, elbow joint function can be impaired. The goal of open reduction and internal fixation (ORIF) is restoration of normal anatomy

2014 eMedicine Surgery

68. Olecranon Fractures (Overview)

of the bone of the proximal ulna from the base of the coronoid process (down arrow) proximally. The trochlear notch (up arrows; also called the semilunar notch) is the articular surface shown between the two arrows. The ulnar nerve lies on the posterior aspect of the elbow, posterior to the medial collateral ligament. The ulnar nerve sweeps anteriorly to join the ulnar artery. The ulnar neurovascular bundle may be at risk during Kirschner wire (K-wire) fixation. Fracture displacement is largely due (...) reduction and internal fixation of the fracture with a 7.3-mm cannulated screw and 1.6-mm cable. Lateral radiograph demonstrating the threads of the screw engaging the cortices of the ulna. Typical relatively transverse olecranon fracture. Pediatric olecranon fracture. The olecranon process consists of the bone of the proximal ulna from the base of the coronoid process (down arrow) proximally. The trochlear notch (up arrows; also called the semilunar notch) is the articular surface shown between the two

2014 eMedicine Surgery

69. Medial Humeral Condyle Fracture (Overview)

of metaphyseal bone is found attached to the avulsed fragment. If the fragment is incarcerated within the joint, the fragment may become adherent to the coronoid process of the ulna. When the fragment is incarcerated within the joint, the universal finding is a thick fascial band that binds the ulnar nerve to the underlying muscle. This thick fascial band is responsible for ulnar nerve dysfunction, either acutely or as a late finding. Other elbow fractures may be associated with medial epicondyle fractures (...) , and care must be taken to recognize the full extent of the injury. Associated injuries include radial neck fractures, olecranon fractures, and coronoid process fractures. Previous Next: Etiology Medial condyle fracture The following three possible mechanisms for medial condyle fracture [ , , , , , , , , , ] have been described: A fall on the palm of an outstretched arm, with the elbow forced into valgus (see the first image below) A fall on the point of the elbow (apex of the flexed elbow

2014 eMedicine Surgery

70. Radial Head Fractures (Treatment)

fractures are used (see the image below). Surgical treatment options include ORIF with plates and screws, excision of fragments, or radial head replacement. Floating elbow. Combined Monteggia fracture with dislocation and supracondylar humerus fractures. Treatment of a floating elbow requires fixation of both fractures. Surgical treatment of so-called terrible triad injuries of the elbow (elbow dislocations with concomitant fractures of the radial head and the coronoid process) is controversial (...) = processing > Radial Head Fractures Treatment & Management Updated: Aug 09, 2018 Author: Steven I Rabin, MD; Chief Editor: Thomas M DeBerardino, MD Share Email Print Feedback Close Sections Sections Radial Head Fractures Treatment Approach Considerations The goal of treatment of radial head fractures and dislocations, as with all orthopedic injuries, is a successful functional outcome. A successful outcome correlates directly with accuracy of anatomic reduction, restoration of mechanical stability

2014 eMedicine Surgery

71. Olecranon Fractures (Follow-up)

for noncomminuted fractures. The goal is to convert the extensor force of the triceps to a dynamic compression force along the articular surface. Tension band wiring is indicated for displaced fractures proximal to the coronoid process that are not at risk of compressing the olecranon fossa. Tension band wiring is contraindicated if the articular surface is comminuted and unstable. [ , , , , ] Takada et al have described a minimally invasive technique for tension band wiring. [ ] The fracture is usually reduced (...) . [ ] The challenges associated with appropriate technical placement of the hardware are underestimated. Despite good functional results, Schneider et al found technical imperfections to be common. [ ] Previous Next: Plate Fixation Plate fixation is most commonly recommended for comminuted fractures for which tension band wire fixation is not feasible. It also is indicated for fractures that involve the coronoid process or extend distal to the coronoid process, including those extending into the shaft

2014 eMedicine Surgery

72. Supracondylar Humerus Fractures (Follow-up)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI2OTU3Ni10cmVhdG1lbnQ= processing > Supracondylar Humerus Fractures Treatment & Management Updated: Feb 15, 2017 Author: Jiun-Lih Jerry Lin, MBBS, MS(Orth); Chief Editor: Jeffrey D Thomson, MD Share Email Print Feedback Close Sections Sections Supracondylar Humerus Fractures Treatment Approach Considerations The main goals of surgical treatment of supracondylar humerus fractures are as follows: Prevent further injury Restore normal anatomy Provide an optimal environment for healing If these goals are met (...) to be sacrificed for later anterior transposition. Nerve then is carefully retracted and protected with vascular tape. The olecranon is isolated, and a small incision is made in the medial or lateral capsule for passage of a probe into the trochlea to palpate the level of the coronoid process. The apex of the chevron osteotomy then is planned 3-5 mm proximal to the coronoid, with the apex directed distally. (This also will correlate with a point just proximal to the radioulnar articulation.) Because the author

2014 eMedicine Surgery

73. Fracture, Elbow (Diagnosis)

and the coronoid process of the ulna; this can be mistaken for the ossification center of the trochlea. ED management consists of immobilization of the forearm in flexion and pronation and the wrist in flexion. Lateral epicondyle fracture Lateral epicondyle fracture is very rare and is usually due to an avulsion fracture. Fracture of the lateral humeral epicondyle can be mistaken for the radiolucency of the epiphysis. [ ] Treatment is immobilization with the elbow flexed to 90 degrees and the forearm (...) Fracture, Elbow (Diagnosis) Elbow Fracture: Background, Pathophysiology, Extra-articular Fracture Patterns Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODI0NjU0LW92ZXJ2aWV3 processing > Elbow Fracture Updated

2014 eMedicine Emergency Medicine

74. Fracture, Elbow (Overview)

and the coronoid process of the ulna; this can be mistaken for the ossification center of the trochlea. ED management consists of immobilization of the forearm in flexion and pronation and the wrist in flexion. Lateral epicondyle fracture Lateral epicondyle fracture is very rare and is usually due to an avulsion fracture. Fracture of the lateral humeral epicondyle can be mistaken for the radiolucency of the epiphysis. [ ] Treatment is immobilization with the elbow flexed to 90 degrees and the forearm (...) Fracture, Elbow (Overview) Elbow Fracture: Background, Pathophysiology, Extra-articular Fracture Patterns Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODI0NjU0LW92ZXJ2aWV3 processing > Elbow Fracture Updated

2014 eMedicine Emergency Medicine

75. Pediatric Terrible Triad Elbow Fracture Dislocations: Report of 2 Cases. (PubMed)

Pediatric Terrible Triad Elbow Fracture Dislocations: Report of 2 Cases. An elbow dislocation associated with radial head and coronoid process fractures, the terrible triad injury, has an unpredictable outcome in adults and is rare in children. We present 2 such injuries in children, 1 combined with an olecranon fracture, and both with good early clinical outcomes. However, in 1 of the 2 cases, avascular necrosis of the proximal radius was evident on radiographs. Copyright © 2013 American

2013 Journal of Hand Surgery - American

76. Characterization of mandibular fractures using 64-slice multidetector CT (PubMed)

Characterization of mandibular fractures using 64-slice multidetector CT The aim of this study was to characterize mandibular fracture locations using 64-slice multidetector CT (MDCT).CT scans of 138 patients with mandibular fractures who underwent 64-slice MDCT were studied. Mandibular fractures were classified into five types: median, paramedian, angle, condylar and coronoid process. Statistical analysis for the relationship between multiple fractures and type of mandibular fractures (...) was performed using χ(2) test with Fisher's exact test.The percentage of multiple mandibular fractures was 80.9% median type, 74.3% paramedian type, 52.9% angle type and 60.9% condylar type. The resultant data showed a significant relationship between multiple fractures and the median type (p = 0.000), paramedian type (p = 0.002) and condylar type (p = 0.003).The results suggest that multiple fractures are related to the type of mandibular fractures.

Full Text available with Trip Pro

2012 Dentomaxillofacial Radiology

77. Potential Dangers of Tension Band Wiring of Olecranon Fractures: An Anatomic Study. (PubMed)

cadavers with intact proximal ulnas. The K-wires were drilled obliquely through the tip of the olecranon process and directed to engage the anterior ulnar cortex, distal to the coronoid. Using calipers, we measured the distance from the tip of each pin to the anterior interosseous nerve (AIN), ulnar artery, proximal radioulnar joint (PRUJ), and volar cortex of the ulna, as well as the distance from the volar cortex of the ulna to the AIN and ulnar artery. The angle created by the K-wires (...) Potential Dangers of Tension Band Wiring of Olecranon Fractures: An Anatomic Study. Displaced olecranon fractures are often amenable to treatment with open reduction and tension-band wiring. The purpose of this study is to examine the relationships of the tips of K-wires used in a tension-band construct to volar neurovascular structures in the proximal forearm and the proximal radioulnar joint.We performed simulated percutaneous pinnings of the proximal ulna under fluoroscopic guidance on 15

2011 Journal of Hand Surgery - American

78. [Case-control study on combined therapy for preventing postsurgery stiffness after elbow fracture]. (PubMed)

23 to 63 years, averaged (43.53 +/- 7.74) years old; 15 patients had two parts fractures, including humeral intercondylar fractures combined with olecroanon and (or) ulna coronoid process fractures in 8 cases, fractures of exterior and interior humeral condyle combined with capitulum radius in 3 cases, fractures of olecroanon and ulna coronoid process in 3 cases, fractures of olecroanon and capitulum radius in 1 case; other 15 patients had one part fractures, including fractures of exterior (...) or interior humeral condyle in 8 cases,fractures of olecroanon or ulna coronoid process in 6 cases, fractures of capitulum radius in 1 patient. Thirty patients in the past procedure group,including 11 males and 19 females, ranging in age from 24 to 67 years, averaged (46.13 +/- 6.22) years; 15 patients had two parts fractures, including fractures of humeral intercondylar fracture combined with olecroanon and(or) ulna coronoid process in 7 cases, fractures of exterior and interior humeral condyle combined

2011 Zhongguo gu shang = China journal of orthopaedics and traumatology Controlled trial quality: uncertain

79. Management and outcome of 103 acute fractures of the coronoid process of the ulna. (PubMed)

Management and outcome of 103 acute fractures of the coronoid process of the ulna. 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

Full Text available with Trip Pro

2009 The Journal of Bone and Joint Surgery British Volume

80. The effect of anteromedial facet fractures of the coronoid and lateral collateral ligament injury on elbow stability and kinematics. (PubMed)

The effect of anteromedial facet fractures of the coronoid and lateral collateral ligament injury on elbow stability and kinematics. It is postulated that fractures of the anteromedial facet of the coronoid process and avulsion of the lateral collateral ligament lead to posteromedial subluxation and arthritis of the elbow. It is not clear which injuries require internal fixation and whether repair of the lateral collateral ligament is sufficient. We hypothesized that increasing sizes (...) unconstrained elbow-motion simulator was used to simulate active elbow flexion in the vertical position. Varus-valgus angle and internal-external rotational kinematics were recorded with use of an electromagnetic tracking system. Testing was repeated with the coronoid intact and with subtype-I, subtype-II, and subtype-III fractures. Instability was defined as an alteration in varus-valgus angle and/or in internal-external rotation of the elbow. All six coronoid states were tested with the lateral collateral

2009 The Journal of Bone and Joint Surgery. American Volume

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