J Am Acad Orthop Surg, Vol 16, No 9, September 2008
Scott P. Steinmann, MD The coronoid process is one of the main constraints providing ulnohumeral joint stability. The coronoid process and the radial head provide a buttress against posterior displacement of the elbow joint. Fracture of the coronoid process can be either an isolated finding following elbow dislocation or part of a more complex fracture-dislocation. Much attention has been focused on treatment of radial head fractures and lateral ligament reconstruction, although recently, attention has been directed at detection and treatment of coronoid fractures. Surgical approaches to coronoid fractures depend on the condition of the radial head. When an associated radial head fracture is present, a lateral approach to the coronoid fracture is often performed. An isolated coronal fracture is typically approached from the medial side. Intraoperative stress testing may be helpful in assessing the need for surgery and choosing the surgical approach.