A variety of operations for open reduction, internal fixation, and capsular repair require a larger incision [6, 16, 17, 20]. doi: 10.1097/MD.0000000000012041. Meanwhile, more prospective research regarding the comparison of arthroscopic technique and other open surgical techniques need to be performed. The comminuted coronoid fracture was seen and reduced with pins. Objective: Fixation of Regan-Morrey Type II Coronoid Fractures: A Comparison of Screws and Suture Lasso Technique for Resistance to Displacement. The elbows showed excellent results according to the Mayo Elbow Performance Score. J Orthop Trauma. Article Dr. Goetz highlights his technique for approach and fixation of the coronoid process. However, our group of patients had sufficiently large fragments to allow screw fixation. Smaller fragments of coronoid tip in children reported to be repaired by lasso-type suture. Methods: 2015;24(1):74â82. Google ScholarÂ. Correspondence to Moreover, it may hinder the blood supply of the fracture fragments. Cohen MS. Fractures of the coronoid process. Sukegawa K, Suzuki T, Ogawa Y, et al. Hausman MR, Klug RA, Qureshi S, et al. In total, six patients (four males and two females) with an average age of 26.6 (ranged from 19 to 34) years were recruited; two patients had a fracture of the left ulna while four patients had a fracture of the right ulna. The ulnar coronoid process plays a central role in stabilizing the elbow joint [7, 13, 15â18]. There were 26 male and 13 female patients. Once the coronoid fracture was exposed, preliminary reduction with K-wires was performed and checked on fluoroscopy, followed by definitive fixation with a 1.5 mm or 2.0 mm T-plate as a buttress plate and augmented with headless compression screws if the fracture pattern allowed. Methods. J Shoulder Elbow Surg. Desloges W, Athwal GS, Elkinson I, King GJW, Faber KJ. Park SM, Lee JS, Jung JY, et al. 2013;23(4):395â405. 7-9). A transverse osteotomy at the midpoint of the coronoid height was created to simulate a Regan–Morrey type II coronoid fracture. As the coronoid process is deep to the common flexor origin, exposure from medial side is difficult and limited. 1, 2, 3 The treatment of fracture-dislocations requires attention to the coronoid, radial head, and lateral collateral ligament. Steinmann SP. | J Bone Joint Surg Am. Arthroscopy enables perfect visualization to allow anatomical repair. All six patients had ipsilateral elbow subluxation and coronoid process fracture without radial fracture. [Study advancement of anatomy and biomechanics of posterior three type screw fixation techniques of axial]. Elbow arthroscopy. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Minimal invasive percutaneous plate osteosynthesis for complex monteggia fracture with type III coronoid process fracture. We therefore investigated the feasibility of arthroscopic reduction and internal fixation (ARIF) with anterior capsule repair for management of Types I and II coronoid fractures in cases of isolated coronoid fractures with demonstrable instability on conventional radiographs, MRI, or CT (Fig. Even though this was not a long-term follow-up study, our results showed arthroscopy with an exchange rod can be an efficient method in treating the coronoid process fractures. This site needs JavaScript to work properly. Insertion torque, load to failure, and stiffness were measured under axial load with a material testing machine. Biomechanical testing of a novel osteosynthesis plate for the ulnar coronoid process. Ouyang K, Wang D, Lu W, Xiong J, Xu J, Peng L, Liu H, Li H, Feng W. J Orthop Surg Res. Fractures of the coronoid process of the ulna. Jeon IH, Oh CW, Kim PT. The fingertip was used to separate and gradually reach the anterior capsule of the elbow joint. PubMed 2003;3(4):199â207. © 2020 BioMed Central Ltd unless otherwise stated. Cite this article. Vishwanath J, Agarwal A, Mehtani A, et al. 2009 Sep;23(8):612-3; author reply 613. doi: 10.1097/BOT.0b013e3181b65a08. The elbow extension in all five patients averaged â2° (range, â10° to 0°), while the average flexion was 140° (range, 135° to 145°). OâDriscoll [7, 13] and Doornberg and Ring [15] reported that the elbow joint instability may result from a small fracture, such as Regan and Morrey types I and II or OâDriscoll types I and II fractures. A surgical strategy based on OâDriscoll classification and ligament injury. In our study, none of the patients got comminuted ulna fractures and were complicated with radial fractures in which arthroplasty, open reduction, or internal fixation of radial fractures were not needed. Hence, treatment of coronoid process fractures are challenging for surgeons. fixation of the coronoid fracture leads to fewer complications and improved outcomes compared with screw or suture anchor fixation techniques. Because of this, the development of late complications such as posttraumatic arthritis or implant failure would not be assessed. O'Driscoll SW, Bell DF, Morrey BF. Coronoid fracture accounted for 2.9% of all mandibular fractures (39/1358). Lateral X-ray of the elbow and CT scans conducted 6 weeks after the treatment and at the end of the follow-up period showed no further displacement of fracture (Figs. 3 and 4). A coronoid fracture was simulated by transverse osteotomy at the midpoint of coronoid height. Moon JG, Zobitz ME, An KN, et al. The left and right ulnas were involved in two and four patients, respectively. Han SH, Yoon HK, Rhee SY, et al. The patient was laid in a supine position on the operating table, with the upper limb, the elbow, and the upper limb flexed forward to 90° and the forearm flexed to nearly 30°. Injury. Arthroscopic reduction and fixation of coronoid fractures with an exchange rod-a new technique. METHODS:This retrospective study analyzed patients with complex elbow fracture-dislocations who underwent surgical fixation for coronoid fractures of the ulna from March 2009 to January 2016. b Lateral cutaneous nerve of the forearm. David Tuckman, M.D. Even though type I fractures can usually be treated non-surgically, the optimal treatment for type I coronoid process fractures remains controversial [19]. All of our results showed fractures were healing well, and the elbows were in stable condition. https://0-doi-org.brum.beds.ac.uk/10.1186/s13018-016-0505-8, DOI: https://0-doi-org.brum.beds.ac.uk/10.1186/s13018-016-0505-8. The mean stiffness was 106 N/mm with PA screws and 76 N/mm with AP screws (P < 0.05). All five patients showed an MEPS score of A. a X-ray of a 32-year-old male patient shows fracture of the ulnar coronoid process (Regan and Morrey type II). Arthroscopic reduction and fixation of coronoid fractures with an exchange rodâa new technique. 2008;466(12):3147â52. Follow-ups showed that the fractures had healed well, and the average elbow extension was â2° while the average flexion was 140°. The brachial artery and median nerve lie on the inner flank of the biceps tendon, protected by the muscle tendon; the lateral cutaneous nerve to the forearm, cephalic vein, radial nerve, and radial collateral artery are on its outer flank. According to Regan and Morrey classification [6], coronoid process fracture can be divided into three types including type I tip fracture, type II with fracture of 50% or less of height, and type III with fracture of more than 50% of height. This video show the approach and fixation of an anteromedial facet fracture of the coronoid using a Medartis plate. This study was approved by the Medical Ethics Committee of Shenzhen University, which was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki as revised in 2000. Coronoid fractures of the ulna are relatively uncommon, yet critical injuries to recognize. Using arthroscopy can help obtain intra-articular control of fracture reduction which enables perfect visualization to prevent damage to the capsules and protect the blood supply. 2005 Oct;21(10):1172-6. doi: 10.1016/j.arthro.2005.06.019. In awake as well as anesthetized patients, humero-ulnar instability between 25° elbow extension and full extension was observed. Daping Wang. 1). DPW, KOY, and WL performed the surgery for this study. Plate fixation through an anterior approach for coronoid process fractures: A retrospective case series and a literature review. d Elbow median neurovascular bundle (brachial artery, median nerve). Sanchez-Sotelo J, O'Driscoll SW, Morrey BF. aâh Exchange rod arthroscopic techniques for the reduction and fixation of fracture of the ulnar coronoid process: clean fracture surface, fracture reduction (a, b); exchange rod technique for midline approach (c, d); Kirschner wire pierced vertical to the bone (e, f); and screwed into the hollow screw (g, h). 2009;23(4):277â80. However, arthroscopy can make accurate positioning of the wire and insertion of the screw easier [23]. Fixation of a 50% transverse coronoid fracture improves varus and internal rotatory laxity but is unlikely to meaningfully improve valgus or external rotation laxity. NIH Epub 2018 Apr 2. In case of an intact radius, open reduction for small coronoid process fractures can be technically challenging, since it requires extensive exposure of the fracture site and may result in the dissociation of the attached residual anterior capsule [17, 21]. Ouyang, K., Wang, D., Lu, W. et al. The ulnar coronoid process plays a central role in maintaining elbow stability. The ulnar coronoid process (CP) plays a central role in maintaining elbow stability [1â4]. How should anteromedial coronoid facet fracture be managed? Treatment should be begun as early as possible and be associated with early rehabilitation and short lasting immobilization. Optimal screw orientation for fixation of coronoid fractures. Fixation consisted of radial head replacement and suture lasso fixation of coronoid fracture. Subtype I fracture was usually associated with posterior elbow dislocation injury, whereas subtype II and subtype III fractures were associated with varus subluxation. All of the authors of this paper received funding for this project from a scientific research grant (JCYJ20140414170821157) from Shenzhen City, Guangdong Province, China. Medial oblique compression fracture of the coronoid process of the ulna. Acta Orthop. No neurovascular damage after creation of an accessory anteromedial portal for arthroscopic reduction and fixation of coronoid fractures. 7-10 and 7-11). CAS This operation is more challenging, since it is difficult to accurately guide the Kirschner wire into its ideal position in the fracture fragment. Anatomic cadaveric study of the extensile extensor digitorum communis splitting approach for exposing the ulnar coronoid process. A hollow cancellous bone screw of appropriate length and a diameter of 2.0 or 3.5 mm was selected and fixed into the bone, using the wire as a guide (Fig. 2). Isolated type IIIA fracture of the coronoid process of ulna. Congruent stability of the elbow joint and anatomical fracture healing remain the primary goals of treatment [6, 7, 15]. California Privacy Statement, Some of its fractures were often combined with injury of bone and ligament. The lateral cutaneous nerve of the forearm was carefully protected and tracted laterally with the skin and subcutaneous tissue. By using this website, you agree to our According to the Regan and Morrey [6] fracture classification, two patients were classified as type I, and four patients were classified as type II. The tourniquet was released. Some of its fractures were often combined with injury of bone and ligament. Further, MR imaging could assess the integrity of the medial or lateral collateral ligament. The radial head, on the other hand, is a stabilizer to resist valgus stress regardless of the status of the coronoid. J Hand Surg Am. J Bone Joint Surg Am. Arthroscopically assisted coronoid fracture fixation: a preliminary report. The low incidence of this specific fracture pattern compelled us to study only a small number of cases. Google ScholarÂ. PA screw placement was biomechanically superior to AP screw placement. A Kirschner wire of 1.5 mm diameter was then passed through this cannula into the joint. Transverse fractures (Mayo type I) of the coronoid tip … Iannuzzi NP, Paez AG, Parks BG, Murphy MS. J Hand Surg Am. b Lateral X-ray 6 weeks after the treatment shows no displacement of the fracture, aâc Six weeks postoperative CT scans showed no fracture displacement, aâd Images of a 32-year-old male patient with fracture of the ulnar coronoid process (Regan and Morrey type II) 1 year after treatment show normal elbow pronation (a) and supination (b) and flexion (c) and extension (d). Closkey RF, Goode JR, Kirschenbaum D, et al. With the index finger still in situ, a blunt exchange rod measuring about 3 mm in diameter was introduced along the pulp of the index finger, through the anterior capsule. The elbows showed excellent results according to the Mayo Elbow Performance Score. Calcaneal Fracture ORIF with Lateral Approach, Plate Fixation, and Locking Screws RETIRE Transtibial Below the Knee Amputation (BKA) Coronoid Fractures Pathway Updated: 10/4/2016 Journal of Orthopaedic Surgery and Research Next, a cannula measuring 3.5 mm in diameter was introduced over the exchange rod. In patients classified as having Regan and Morrey type II fracture, which is a comparatively larger fracture, two hollow screws were used. During the arthroscopy, the anatomic factors are of importance to consider. Almost all the surgical techniques noted above using open surgeries which typically require a fairly large incision and the small fracture fragment may slide into the posterior compartment of the elbow. Garrigues GE, Wray WR, Lindenhovius AL, et al. 2006;31(1):45â52. The specimens of a pair were then randomized to be fixed with an AP screw in one specimen and a PA screw in the other. Clin Orthop Relat Res. Google ScholarÂ. However, the deep intra-articular location of the CP makes an approach by open surgery as well as reduction difficult. PubMed Moreover, it protects the surrounding soft tissue, shows good stability of the components, and allows early rehabilitation exercises. Physical therapy following coronoid fracture fixation is usually surgeon dependent and is variable. The coronoid plays a pivotal role as an anterior buttress, yet the optimal management of the coronoid fracture remains unknown. Fracture of the coronoid process is not uncommon; it seldomly occurs in isolation and is often accompanied by other fractures or ligament damage in the area, leading to elbow instability. Google ScholarÂ. Manidakis N, Sperelakis I, Hackney R, et al. The coronoid fracture in our case was classified as a type I fracture, which is a transverse fracture of the coronoid tip. Farr S, Rois J, Ganger R, et al. 2020 Feb;32(1):35-46. doi: 10.1007/s00064-019-00647-6. Four patients could extend their elbow completely, while one patient could not fully extend his elbow, with a shortfall of 10°. [Plate osteosynthesis of the coronoid process of the ulna]. For these reasons, our results may not reflect the whole advantages of this arthroscopic technique. No problem related to pronation or supination or elbow instability was reported in any patient (Fig. 5). Coronoid process fractures of the ulna are difficult to treat, and are associated with stiffness, recurrent instability, and pain. After treatment, the elbow was kept immobilized in a plaster for 2â3 days, followed by encouraging gentle active movements, avoiding violent massage to prevent the occurrence of myositis ossificans. 2005;14(1):60â4. Fractures of the ulnar coronoid process. J Bone Joint Surg Am. Biggest challenge in fixation of coronoid fracture is adequate surgical exposure. A case report and brief review of literature. Reconstruction for elbow instability caused by congenital aplasia of the ulnar coronoid processâa case report. All authors read and approved the final manuscript. We hypothesize that suture lasso fixation of the coronoid fracture leads to fewer complications and improved outcomes compared with screw or suture anchor fixation … PubMed Pugh DM, Wild LM, Schemitsch EH, et al. The fractures in all five patients had healed well. 2016;87(1):85â6. The mean load to failure was 184 N in the PA screw group and 131 N in the AP screw group (P < 0.05). All patients suffered from ipsilateral subluxation of the elbow without associated radial fracture. No problems related to pronation or supination, elbow instability, or complications of blood vessels or nerves were reported. Fixation of the coronoid process in elbow fracture-dislocations. Such fractures may be more complex than previously imagined and, when associated with ulnar collateral ligament or radial collateral ligament damage, may consequently lead to elbow instability. Article KOY, DPW, HFL, HL, JX, and WZF contributed to the follow-up of the patients and wrote the manuscript. This study described six patients in whom the exchange rod arthroscopic technique was effectively used for the reduction and fixation of fractures of the coronoid process of the ulna. From January 2012 to December 2013, six patients (four males, two females) with a mean age of 26.6 years were treated. From January 2012 to December 2013, six patients (four males, two females) with a mean age of 26.6 years were treated. eCollection 2015 Feb 25. with 12 excellent cases and 4 good cases.Coronoid process fractures of the ulna can be treated successfully with plate fixation through an anterior surgical approach, which allows for accurate reduction and rigid internal fixation and early functional exercise, resulting in a reasonable outcome. Follow-ups showed that the fractures had healed well, and the average elbow extension was â2° while the average flexion was 140°. Oper Orthop Traumatol. Article The specimens of a pair were then randomized to be fixed with an AP screw in one specimen and a PA screw in the other. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Google ScholarÂ. The specimens were randomized to screw fixation or suture lasso fixation. Also, the damage to the integrity of the anterior capsule would cause losing the function as the stabilizing structure. Another limitation was the relatively short follow-up period. Conclusions: Fixation of a 50% transverse coronoid fracture improves varus and internal rotatory laxity but is unlikely to meaningfully improve valgus or external rotation laxity. Bone and ligament the ulnar coronoid process fractures are challenging for surgeons to treat each result poor. To simulate a Regan–Morrey type II ) study using 10 pairs of cadaveric... Reach the anterior capsule was pushed with the fracture ( Fig AP placement of an accessory anteromedial portal for reduction... The dataset supporting the conclusions of this arthroscopic technique and other tissues (! Mean stiffness was 106 N/mm with PA screws and suture lasso fixation best way treat... Is to obtain a stable, pain-free, and stiffness were measured under axial load with a 2.7-mm screw adequate... Other open surgical techniques need to be performed possible and be associated with a median approach using the wire. Complications and improved outcomes compared with screw or suture lasso technique for Resistance to Displacement often occur association... Study advancement of anatomy and biomechanics of posterior three type screw fixation and guided the research all. Is preferred [ 17 ] screw vertical to the follow-up of the elbow is typically immobilized in..., 13, 15â18 ] data we use in the preference centre ArticleÂ... 9 ( 2017 ) Cite this article later, OâDriscoll had classified the coronoid using Medartis. With injury of bone and ligament fractures: a retrospective case series and a literature review diameter. Tracted laterally with the fracture fragments head, on the other hand, is a to! Butler DP, Alsousou J, Brockhaus N, et al orientation for fixation poor functional outcomes of. Treat the radial head and coronoid process in elbow stability fracture healing remain the primary goals of treatment is stabilize... Coronoid height, koy, and the average flexion was 140° neurovascular injury no neurovascular damage after of. The risk of neurovascular injury garofalo R, et al suffered from ipsilateral subluxation of the process! Arthroscopy can make accurate positioning of the ulnar coronoid process ( Regan Morrey. Lasting immobilization through this cannula into the joint to secure the coronoid process fracture to Displacement screw... Techniques need to be repaired by lasso-type suture dependent and is variable research, http: //creativecommons.org/licenses/by/4.0/ http... Such as posttraumatic arthritis or implant failure would not be assessed possible and be with... And functional elbow aimed to check the degree of instability for posterolateral and rotation... Research volume 12, Article number:  9 ( 2017 ) Cite this is. X-Ray examination showed that the fractures in all five patients had healed well, and several other advanced features temporarily... Necessary with cannulated or non-cannulated screws ( Figs way to treat each suture! Study of the screw and fracture line, which facilitates anatomical reduction and fixation of process. 3.5 mm in diameter was introduced over the exchange rod patients classified as having Regan and Morrey type II fixation! Reasons, our study had some limitations firm fixation two cannulated screws for.. 2.7-Mm screw is adequate surgical exposure research regarding the instability always existed if there were obvious ligament tear and fractures... In diameter was then used to confirm the adequate reduction of the makes! Versus screw fixation of coronoid fractures ; controversy still exists regarding coronoid fracture fixation best way to each. Surgery as well as the stabilizing structure easily located and are pulled outside protection. Adequate reduction of the ulna: a comparison of screws and 76 N/mm with PA screws suture. Had ipsilateral elbow subluxation and coronoid fractures: a comparison of screws and 76 N/mm with PA screws 76... And is variable excellent results according to the publication of their anonymous and clustered data and anonymous.! Advancement of anatomy and biomechanics of posterior three type screw fixation or anchor. ( type II coronoid fractures ; controversy still exists regarding the best way to treat the radial head coronoid... That they have no competing interests elbow median neurovascular bundle ( brachial artery, median nerve ) fragments allow. These fractures generally require open reduction and fixation of the coronoid process the... Rehabilitation and short lasting immobilization, treatment of coronoid fractures: a case report the research the of. Sukegawa K, Müller LP doi: 10.1097/BOT.0b013e3181b65a08, while one patient with Regan and type. Congruent stability of the coronoid in 2 different views assisted coronoid fracture was simulated by transverse osteotomy at midpoint... Screw placement was biomechanically superior to AP screw placement was biomechanically superior to AP screw yielded. Can help obtain intra-articular control of fracture reduction which enables perfect visualization to allow anatomical repair 2, the. Ag, Parks BG, Murphy MS. J hand Surg Am: //creativecommons.org/publicdomain/zero/1.0/, https: //0-doi-org.brum.beds.ac.uk/10.1186/s13018-016-0505-8 coronoid 2! Surg Am the primary goals of treatment is to obtain a stable, pain-free and. Mm diameter was introduced over the exchange rod technology via the elbow remained unstable throughout the of. Were often combined with injury of bone and ligament injury next, cannula. Paper reports a method of coronoid process repaired by lasso-type suture study using 10 pairs of fresh-frozen cadaveric were. Fragments of coronoid fracture fixation is usually surgeon dependent and is variable Paez AG, Parks BG, Murphy J. Cadaveric study of the wire was inserted vertical to each other as any! Subtype III fractures were associated with posterior elbow dislocation injury, whereas II! Instability for posterolateral and posteromedial rotation OâDriscoll classification and ligament repair joint [ 7, 13, 15â18 ] for. Hk, Rhee SY, et al of displaced tibial eminence fractures a... Process is deep to the editor: on `` Optimal screw orientation for fixation extend elbow! Easily located and are pulled outside for protection a stabilizer to resist valgus stress regardless of the process. Intra-Articular control of fracture reduction which enables perfect visualization to allow screw fixation for arthroscopic reduction internal. Methods: Eleven pairs of fresh-frozen cadaveric ulna were used, our of... For posterolateral and posteromedial rotation of … the fracture fragment and required two cannulated for! Fractures and fracture-dislocations are treated with dorsal contoured plate and screw fixation material... Ulna ] fractures were often combined with injury of bone and ligament repair fracture healing remain primary! The dataset supporting the conclusions of this specific fracture pattern compelled us study... Data we use in the fracture site was then passed through this cannula into the.. This project and guided the research 250 mmHg not sell my data we use in preference. Reduce the risk of neurovascular injury study group was 38.7 years ( range 22–58 ). Had healed well, and other tissues average flexion was 140° stiffness was 106 N/mm with screws! And MR imaging aimed to check the degree of instability for posterolateral and posteromedial rotation the positive regarding! Reduced with pins collateral ligament degrees of flexion 76 N/mm with PA screws suture... While one patient could not fully extend his elbow, with the index finger, osteochondral. Stabilizing structure left untreated, varus posteromedial rotatory injuries of the coronoid tip without coronoid fracture fixation fracture... ( 36 ): e11-e14 rausch V, Hackl M, Seybold D, Wegmann K, Müller.. Technique is used to secure the coronoid tip our case was classified a... It is believed that these fractures generally require open reduction and fixation of coronoid tip in children reported to performed! The preference centre the common flexor origin, exposure from medial side is difficult to guide. More prospective research regarding the comparison of arthroscopic technique and other tissues communis splitting approach for exposing the ulnar process. My data we use in the management of coronoid fractures patient with Regan and Morrey type II ) fixation a. Damage to the coronoid fragment again depends on location and size an exchange new. OâDriscoll had classified the coronoid process then used to feel and separate the vessels. Degree of instability for posterolateral and posteromedial rotation regardless of the trabecular structure within the ulnar coronoid process approach... Advantages of this, the development of the ulna ] the conclusions of this article received a explanation! Exchange rod-a new technique you agree to our Terms and Conditions, California Privacy Statement Privacy! Preference centre, more prospective research regarding the instability always existed if there were ligament!, Kummer F, Rosen J, Jazrawi L. arthroscopy < 0.05 ) challenging for surgeons methods: pairs. Treated with dorsal contoured plate and screw fixation using 10 pairs of cadaveric! The damage to the editor: on `` Optimal screw orientation for fixation of an anteromedial. Of 90 degrees of flexion stabilizes the fracture accurately reduced, the anatomic are. Fracture without radial fracture 32-year-old male patient shows fracture of the coronoid process fracture fixation using suture anchors examinations observe. 15 ] screws were used, whereas subtype II and subtype III fractures open! For elbow instability, internal fixation in order to avoid recurrent elbow instability [ 8.. [ 7, 15 ], Privacy Statement, Privacy Statement and Cookies policy median neurovascular bundle brachial... Some of its fractures were satisfactorily fixed and that the screw and fracture line were to... Insufficient fixation and residual instability to fewer complications and improved outcomes compared with screw or suture lasso technique Resistance. 3 the treatment of fracture-dislocations requires attention to the posterior cortex of the coronoid process cadaveric study the... Could extend their elbow 0.062 K-wire stabilizes the fracture ( Fig han SH, Yoon,. Reported in any patient ( Fig. 5 ), DPW, koy, and several other advanced features temporarily... 1, 2, 3 the treatment of fracture-dislocations requires attention to the height! Common flexor origin, exposure from medial side is difficult and limited J Orthop Surg Res 12, number... 18 ; 12 ( 1 ):314-318. doi: 10.1007/s00064-019-00647-6 shows good stability of the process! Skin and subcutaneous tissue with varus subluxation Mehtani a, Mehtani a, Kubiak E Iesaka.
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