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Coronoid Process Fracture

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141. Pediatric Complex Divergent Elbow Dislocation. (Abstract)

of the injury, proper radiographic studies are imperative. In contrast to some earlier reports that advise a conservative approach, we performed a very aggressive operative treatment. To ensure anatomic reconstruction of the elbow, surgical exposure of the various injuries was performed first. After gross reduction of the joint dislocation, definitive osteosynthesis of the distal radius fracture was performed. Subsequently, the coronoid process and lateral collateral ligament could be repaired anatomically (...) Pediatric Complex Divergent Elbow Dislocation. A divergent dislocation of the elbow is a very rare injury, and only a few cases have been described in the literature. It is characterized as a dorsal dislocation of the ulnohumeral joint combined with a lateral dislocation of the proximal radius. All three articulations of the elbow joint are involved. Like in our case, it can be accompanied by an avulsion fracture of the coronoid and a distal radius fracture. For correct understanding

2010 Journal of Orthopaedic Trauma

142. Management and outcome of 103 acute fractures of the coronoid process of the ulna. Full Text available with Trip Pro

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

2009 The Journal of Bone and Joint Surgery British Volume

143. Scoring mandibular fractures: a tool for staging diagnosis, planning treatment, and predicting prognosis. (Abstract)

Scoring mandibular fractures: a tool for staging diagnosis, planning treatment, and predicting prognosis. Mandibular fractures (MF) are a daily problem in maxillofacial surgery. A staging system for classifying MF is of paramount importance to plan surgery, to define prognosis, and to exchange information among trauma centers. In this article, a classification for MF is proposed.The mandible is divided into six sites (symphysis, body, angle, ramus, coronoid, and condyle) and the mandibular (...) nerve divides the alveolar process (i.e., the upper part containing teeth) from the basal bone (placed caudally with respect to the nerve). MF can be summarized using three abbreviations: A = alveolar, B = basal, and C = complete. Consequently, MFs are staged as follows: F in situ = a greenstick fracture; F1 = a single mobile fragment of alveolar or basal bone; F2 = double mobile fractures of the alveolar or basal portion or a single complete separation of the mandibular arch continuity; F3

2009 Journal of Trauma

144. Proximal ulna fractures. (Abstract)

Proximal ulna fractures. Proximal ulna fractures are relatively common. They range in severity from a simple transverse olecranon fracture to a highly complex fracture dislocation involving a comminuted coronoid process. The anatomy, fracture pathology, treatment approach, and rehabilitation are presented in this article.

2009 Journal of Hand Surgery - American

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

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

146. Complex varus elbow instability: a terrible triad model. (Abstract)

Complex varus elbow instability: a terrible triad model. The terrible triad is a debilitating injury that involves elbow dislocation with injury to the lateral collateral ligament (LCL) complex, the radial head, and the coronoid process. This study investigated the role of these components in varus stability of the elbow.We investigated the role of these components in varus stability of the elbow using 10 cadaveric fresh frozen upper extremities. The testing order allowed each of four states (...) to be tested (intact, LCL complex deficient or repaired, radial head resected or replaced) at two flexion angles and multiple coronoid resection levels. Values for restraining load (newtons [N]) at 1.5 cm of varus displacement were obtained on a materials testing machine.Beyond a 50% loss of the coronoid process, neither repair of the LCL nor replacing the radial head alone resulted in a statistically significant increase in varus stability. For a loss of the coronoid process between 67-75%, repair

2009 Journal of Shoulder and Elbow Surgery

147. Mandibular Dislocation

fractured sites are the body of the mandible, condyle, angle, symphysis, ramus and the coronoid process. The cause of the injury may be road traffic accidents, assault, falls, industrial injuries or sports injuries but the relative number of each varies considerably between countries and areas. Under the age of 25, dental trauma accounts for more lost teeth than caries or gum disease. [ ] In terms of violence, young males are most at risk with alcohol an aggravating factor. Women and children are much (...) Mandibular Dislocation Mandibular Fractures. Common Mandibular Fractures | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Mandibular Fractures and Dislocations Authored by , Reviewed by | Last edited 10 Jun 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK

2008 Mentor

148. Management of the fractured edentulous atrophic mandible. (Abstract)

from 1980, both to 30th January 2006. Last search was done in January 2006.Randomised controlled trials involving people over 55 years of age with fractures in the symphysis, parasymphysis, body, angle, ramus, condyle, and coronoid process of atrophic edentulous mandibles in which the fracture was a result of trauma, implant insertion or due to pathological fracture. Any studies that compared methods of management (open or closed reduction or fixation) were to be included.Screening of eligible (...) Management of the fractured edentulous atrophic mandible. Fractures of the atrophic and edentulous (toothless) mandible (lower jaw) are fairly common in elderly people. Atrophy and weakening tend to occur as a result of reduced vascularity and decreased blood flow. Treatment options for reduction and fixation include closed and open techniques, with the degree of atrophy having a significant influence on the type of treatment. Many methods have been proposed for treating fractures

2007 Cochrane

149. The treatment of isolated ulnar fractures in adults: a systematic review

ulnar, olecranon and coronoid process fractures. Participants included in the review Adult patients with ulnar shaft fractures. Studies of child participants, olecranon fractures, and combined radial and ulnar fractures were excluded. Outcomes assessed in the review The outcome measures were time to union, nonunion rate, functional outcome, residual deformity and complication rates. Five publications which did not define outcome measures sufficiently to allow analysis, or were seriously flawed, were (...) the results, but should be viewed with much caution because of limitations in the quality of the review process. Implications of the review for practice and research The authors did not state any implications for further research and practice. Bibliographic details Mackay D, Wood L, Rangan A. The treatment of isolated ulnar fractures in adults: a systematic review. Injury 2000; 31(8): 565-570 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Adult; Bone Nails; Bone Plates; Casts, Surgical

2000 DARE.

150. Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus. (Abstract)

wires directed out the anterior ulnar cortex distal to the coronoid process and bent 180degrees and impacted into the olecranon proximally, and two 22- gauge, figure-of-eight, stainless steel tension wires. A single surgeon used this technique for exposure of a fracture (16 patients) or nonunion (29 patients) of the distal humerus in 45 consecutive patients. One patient returned to activity too soon, had loosening of the wire fixation, and required a second operation for plate fixation of the ulna (...) Olecranon osteotomy for exposure of fractures and nonunions of the distal humerus. Although olecranon osteotomy provides excellent exposure of the distal humerus, enthusiasm for this approach has been limited by reports suggesting numerous complications. It has been suggested that specific techniques for creating and repairing an olecranon osteotomy may help limit complications. This paper describes a technique for olecranon osteotomy using an apex, distal, chevron-shaped osteotomy, Kirschner

2004 Journal of Orthopaedic Trauma

151. Transverse divergent dislocation of the elbow with ipsilateral distal radius fracture in a child. (Abstract)

Transverse divergent dislocation of the elbow with ipsilateral distal radius fracture in a child. We report a rare case of an irreducible transverse divergent dislocation of the elbow with an ipsilateral distal radius torus fracture and a fracture of the coronoid process in a 9-year-old male. Closed reduction of the elbow was attempted, but the humeroulnar joint remained dislocated. At surgery, the avulsed anterior band of the medial collateral ligament complex of the elbow was found

2007 Journal of Orthopaedic Trauma

152. Surgical treatment of persistent dislocation or subluxation of the ulnohumeral joint after fracture-dislocation of the elbow. (Abstract)

of the olecranon were treated with temporary hinged external fixation, preservation, or reconstruction of both the coronoid process and radiocapitellar contact and with repair or reconstruction of the lateral collateral ligament complex. There were 9 men and 4 women with an average age of 45 years. Seven patients had a terrible triad pattern injury and 6 had a posterior Monteggia pattern injury. All 13 patients had fracture of the radial head and 10 patients had fracture of the coronoid process.At an average (...) Surgical treatment of persistent dislocation or subluxation of the ulnohumeral joint after fracture-dislocation of the elbow. To review the results of surgical reconstruction of posttraumatic elbow instability in the setting of either intact or repaired olecranon process using a protocol incorporating hinged elbow fixation.Thirteen consecutive patients with ulnohumeral instability after a fracture-dislocation of the elbow, adequate articular surfaces, and adequate, stable alignment

2004 Journal of Hand Surgery - American

153. Loss of alignment after surgical treatment of posterior Monteggia fractures: salvage with dorsal contoured plating. (Abstract)

and 12 patients had subluxation or dislocation of the ulnohumeral joint. Sixteen patients had fracture of the radial head and 9 patients had fracture of the coronoid process. Nine patients had ancillary procedures on the radial head, 4 had ancillary procedures on the coronoid, 5 had hinged external fixation, and one had fascial arthroplasty. Seven patients had another surgery before the final evaluation related to a complication in 6 patients and a to subsequent injury in 1 patient.At the final (...) Loss of alignment after surgical treatment of posterior Monteggia fractures: salvage with dorsal contoured plating. To review the results of internal fixation with a dorsal contoured plate in patients with malalignment after internal fixation of a posterior Monteggia fracture.Seventeen patients with malalignment after surgical treatment of a posterior Monteggia fracture were treated with realignment of the ulna and fixation with a contoured dorsal plate. Fifteen patients had loose fixation

2004 Journal of Hand Surgery - American

154. Elbow dislocation with intra-articular fracture: the results of operative treatment without repair of the medial collateral ligament. (Abstract)

a 5-year period, a single surgeon operated on 34 patients with a posterior dislocation of the elbow associated with one or more intra-articular fractures. The mean age of these 19 men and 15 women was 48 years. Associated fractures included the capitellum, trochlea, and lateral epicondyle in 3 patients; the olecranon in 1 patient; and the radial head in 30 patients (with concomitant fracture of the coronoid process-the so-called "terrible triad" of the elbow-in 22 patients, and concomitant (...) fracture of the coronoid and olecranon in 1 patient). Operative treatment consisted of open reduction internal fixation (ORIF) or prosthetic replacement of all fractures and reattachment of the origin of the lateral collateral ligament (LCL) complex to the lateral epicondyle. The MCL was not repaired.Two patients (1 with a terrible triad injury and 1 with fracture of the capitellum and trochlea) had postoperative instability related to noncompliance, had reconstructive procedures, and were considered

2007 Journal of Hand Surgery - American

155. Reconstruction of Mason type-III and type-IV radial head fractures with a new fixation device: 23 patients followed 1-4 years. Full Text available with Trip Pro

using a new fixation device (FFS; Orthofix). 14 Mason type-III fractures with 2 concomitant olecranon fractures and 1 ulnar nerve lesion, and 11 type-IV fractures with 2 olecranon fractures and 2 fractures of the coronoid process were treated. 2 patients were lost to follow-up. In 7 cases of joint instability, an elbow fixator with motion capacity was applied after ORIF of the radial head.No radial head resection was necessary. No secondary dislocations or nonunion occurred. The Morrey elbow score (...) Reconstruction of Mason type-III and type-IV radial head fractures with a new fixation device: 23 patients followed 1-4 years. Treatment options in radial head fractures of Mason types III and IV range from open reduction and internal fixation (ORIF) to radial head resection with or without prosthetic replacement.In a prospective study, the radiographic and clinical outcome was evaluated in 23 patients (age median 51 years) with 23 complex radial head fractures median 2 (1-4) years after ORIF

2007 Acta Orthopaedica

156. The fractured edentulous atrophic mandible--open or closed treatment? Full Text available with Trip Pro

restrictions.Studies were selected if they were randomised controlled trials involving people over 55 years of age with fractures in the symphysis, parasymphysis, body, angle, ramus, condyle, and coronoid process of atrophic edentulous mandibles in which the fracture was a result of trauma, implant insertion or due to pathological fracture. Any studies that compared methods of management (open or closed reduction or fixation) were selected.Screening of eligible studies was conducted in duplicate and independently (...) The fractured edentulous atrophic mandible--open or closed treatment? The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, Medline and Embase were used for searches. The Internet was searched for potentially relevant meta-analyses and non-Cochrane systematic reviews, ongoing clinical trials and published dissertations. Reference lists of identified studies were cross-checked for any potentially relevant clinical trials. There were no language

2007 Evidence Based Dentistry

157. Monteggia fractures in adults: long-term results and prognostic factors. (Abstract)

, Jupiter type IIa fracture, fracture of the radial head, coronoid fracture, and complications requiring further surgery. Bado type II Monteggia fractures, and within this group, Jupiter type IIa fractures, are frequently associated with fractures of the radial head and the coronoid process, and should be considered as negative prognostic factors for functional long-term outcome. Patients with these types of fracture should be informed about the potential risk of functional deficits and the possible (...) Monteggia fractures in adults: long-term results and prognostic factors. The objective of this retrospective study was to correlate the Bado and Jupiter classifications with long-term results after operative treatment of Monteggia fractures in adults and to determine prognostic factors for functional outcome. Of 63 adult patients who sustained a Monteggia fracture in a ten-year period, 47 were available for follow-up after a mean time of 8.4 years (5 to 14). According to the Broberg and Morrey

2007 The Journal of Bone and Joint Surgery British Volume

158. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. Full Text available with Trip Pro

procedure were excluded. Of the twenty-six patients, twenty-two had an associated elbow dislocation, and thirteen of them also had an associated fracture of the coronoid process. Patients were prospectively followed at three, six, twelve, and twenty-four months. Self-reported limb function, general health, range of motion, and isometric strength were assessed by an independent observer.Following treatment of the injury, significant decreases in self-reported and measured impairments were noted over time (...) Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. Comminuted fractures of the radial head are challenging to treat with open reduction and internal fixation. Radial head arthroplasty is an alternative treatment with results that compare favorably with those reported after open reduction and internal fixation of similar fractures. The purpose of this study was to evaluate the two-year outcomes and the rate of recovery of a closely

2006 The Journal of Bone and Joint Surgery. American Volume

159. Effective treatment of fracture-dislocations of the olecranon requires a stable trochlear notch. (Abstract)

and all of the patients with posterior injuries had an associated fracture of the coronoid process of the ulna. One of 10 patients with anterior and 13 of 16 patients with posterior injuries had fracture of the radial head. Only one patient had a true dislocation of the ulnohumeral joint. In the other 25 patients the articular surfaces remained apposed. All 26 patients were treated operatively and followed up for at least 3 years (average, 6 years). The results were good or excellent in 21 of 26 (...) patients according to the system of Broberg and Morrey. The five unsatisfactory results were related to inadequate fixation of the coronoid with subsequent arthrosis (three patients), proximal radioulnar synostosis (three patients), and a subsequent fracture of the distal humerus (one patient). Fracture-dislocations of the olecranon occur in anterior and posterior patterns with specific injury characteristics and pitfalls. The key to effective treatment is stable restoration of the trochlear notch.

2004 Clinical Orthopaedics and Related Research

160. Nondisplaced elbow fractures: A commonly occurring and difficult diagnosis. (Abstract)

obtained. Each specimen was dissected, and the injury described. A musculoskeletal radiologist, blinded to dissection results, examined the radiographs.Dissection revealed 39 fractures of 96 sites examined. A total of 14 fractures were nondisplaced, 7 involving the coronoid process. Radiographs identified 27 fractures. Of the 12 missed fractures, 11 were nondisplaced. Radiographic diagnosis of nondisplaced elbow fractures demonstrated a 21% sensitivity, 95% specificity, 50% positive predictive value (...) Nondisplaced elbow fractures: A commonly occurring and difficult diagnosis. Determine the sensitivity and specificity of radiography in identifying nondisplaced elbow fractures after trauma. Our hypothesis is that nondisplaced fractures occur commonly following impact injuries and are difficult to diagnose with plain film imaging.An in vitro double-blinded study of 16 cadaver arms was designed, simulating axial forearm trauma. Following injury, anteroposterior and lateral radiographs were

2006 American Journal of Emergency Medicine

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