From the Research
The surgical procedure for open reduction and internal fixation of the coronoid process typically involves making an incision to access the fracture site, anatomical reduction of the fracture fragments, and fixation using screws, plates, or sutures depending on fragment size and location, with the approach may be anterior or posterior based on fracture characteristics, as reported in the most recent study 1. The approach to the coronoid process fracture can vary, with some studies suggesting an anterior minimally invasive approach using a mini-plate for fixation, which can achieve anatomic reduction, stable fixation, and anterior capsular repair 1. Other studies have reported the use of a modified retromandibular approach indirectly from the anterior edge of the parotid gland, which has many advantages, including a simple and short incision, a completely exposed operative field, and reduced risk to the facial nerve 2. The fixation methods used can include 2.0-2.7mm screws for larger fragments or suture fixation for smaller fragments, with post-operative immobilization for 1-2 weeks followed by progressive range of motion exercises 3. It is also worth noting that arthroscopic repair of coronoid process fractures is a novel technique that has been reported, which can provide stable fixation, minimal soft-tissue violation, and restoration of highly functional elbow range of motion 4. The choice of approach and fixation method will depend on the specific characteristics of the fracture, as well as the surgeon's preference and experience. Some key points to consider when performing open reduction and internal fixation of the coronoid process include:
- Anatomical reduction of the fracture fragments is crucial to restore elbow stability and prevent chronic instability or arthritis
- The approach used should be based on the fracture characteristics and the surgeon's preference and experience
- Fixation methods should be chosen based on the size and location of the fracture fragments
- Post-operative immobilization and rehabilitation exercises are important to ensure optimal outcomes Overall, the goal of open reduction and internal fixation of the coronoid process is to restore elbow stability, prevent chronic instability or arthritis, and improve functional outcomes, as reported in the most recent and highest quality study 1.