Coronoid Fracture

Question 1

traumatic elbow fractures that are generally pathognomonic for an episode of elbow instability

Answer 1

coronoid fracture

Question 2

coronoid fractures are traumatic elbow fractures that are generally pathognomonic for ____

Answer 2

an episode of elbow instability

Question 3

coronoid fractures commonly occur with ____

Answer 3

elbow dislocation and recurrent instability after dislocation

Question 4

mechanism

Answer 4

traumatic shear injury

Question 5

typically occurs as distal humerus is driven against coronoid with an episode of severe _____ stress or posterior subluxation

Answer 5

varus

Question 6

typically occurs as distal humerus is driven against coronoid with an episode of severe varus stress or ____ subluxation

Answer 6

posterior

Question 7

fractures at the _____ can amplify elbow instability

Answer 7

coronoid base

Question 8

anterior bundle of the medial ulnar collateral ligament attaches to the _____ 18 mm distal to tip

Answer 8

sublime tubercle

Question 9

anterior bundle of the medial ulnar collateral ligament attaches to the sublime tubercle _____ mm distal to tip

Answer 9

18

Question 10

anterior capsule attaches _____ mm distal to the tip of the coronoid

Answer 10

6

Question 11

_____ attaches 6 mm distal to the tip of the coronoid

Answer 11

anterior capsule

Question 12

associated conditions:

Answer 12

posteromedial rotatory instability
posterolateral rotatory instability
olecranon fracture-dislocation
terrible triad of elbow

Question 13

coronoid anteromedial facet fracture and LCL disruption

Answer 13

posteromedial rotatory instablity

Question 14

what is involved in posteromedial rotatory instability

Answer 14

coronoid anteromedial facet fracture and LCL disruption

Question 15

posterolateral rotatory instability involves what

Answer 15

coronoid tip fracture, radial head fracture, and LCL injury

Question 16

coronoid tip fracture, radial head fracture, and LCL injury

Answer 16

posterolateral rotatory instability

Question 17

usually associated with a large coronoid fracture

Answer 17

olecranon fracture dislocation

Question 18

what is the terrible triad of elbow

Answer 18

coronoid fracture (transverse fracture pattern), radial head fracture, and elbow dislocation

Question 19

coronoid fracture (transverse fracture pattern), radial head fracture, and elbow dislocation

Answer 19

terrible triad of elbow

Question 20

is the coronoid tip intra or extra articular

Answer 20

intra-articular

Question 21

medial facet important for ____ stability

Answer 21

varus

Question 22

_____ important for varus stability

Answer 22

medial facet

Question 23

coronoid functions as an anterior buttress of the ____

Answer 23

olecranon greater sigmoid notch

Question 24

oronoid functions as an _____ buttress of the olecranon greater sigmoid notch

Answer 24

anterior

Question 25

important in preventing recurrent posterior subluxation

Answer 25

coronoid

Question 26

coronoid is important in preventing recurrent _____

Answer 26

posterior subluxation

Question 27

primary resistor of elbow subluxation or dislocation

Answer 27

coronoid

Question 28

coronoid is primary resistor of ____

Answer 28

elbow subluxation or dislocation

Question 29

presentation:

Answer 29

elbow deformity & swelling elbow pain forearm or wrist pain may be a sign of associated injuries

Question 30

inspection and palpation will demonstrate:

Answer 30

varus or valgus deformity ecchymosis & swelling diffuse tenderness

Question 31

recommended radiographs

Answer 31

AP and lateral of the elbow

Question 32

useful for high grade injuries and comminuted fractures

Answer 32

CT

Question 33

CT scan usage

Answer 33

useful for high grade injuries and comminuted fractures

Question 34

nonoperative management includes:

Answer 34

brief period of immobilization, followed by early range of motion

Question 35

non op indications

Answer 35

Type I, II, and III that are minimally displaced with stable elbow

Question 36

Type I, II, and III that are minimally displaced with stable elbow op or non op

Answer 36

non op

Question 37

operative techniques

Answer 37

ORIF with medial approach ORIF with posterior approach hinged external fixation

Question 38

ORIF with medial approach indications

Answer 38

Type I, II, and III with persistent elbow instability posteromedial rotatory instability

Question 39

Type I, II, and III with persistent elbow instability posteromedial rotatory instability

Answer 39

ORIF with medial approach

Question 40

indications for ORIF with posterior approach

Answer 40

olecranon fracture dislocation terrible triad of elbow

Question 41

olecranon fracture dislocation terrible triad of elbow

Answer 41

ORIF with posterior approach

Question 42

indications for hinged external fixation

Answer 42

large fragments poor bone quality difficult revision cases to help maintain stability

Question 43

large fragments poor bone quality difficult revision cases to help maintain stability

Answer 43

hinged external fixation

Question 44

ORIF with medial approach interval

Answer 44

medial exposure through an interval between two heads of FCU

Question 45

ORIF with medial approach-exposure more anteriorly through a split in ____ mass

Answer 45

flexor pronator

Question 46

cerclage wire or No. 5 suture through ulna drill holes for Type ____ injuries

Answer 46

1

Question 47

ORIF with retrograde cannulated screws or plate for Type _____

Answer 47

2 or 3

Question 48

type 1 technique

Answer 48

cerclage wire or No. 5 suture through ulna drill holes

Question 49

type 2 or 3 technique

Answer 49

ORIF with retrograde cannulated screws or plate

Question 50

ORIF with buttress plate fixation or pins and lateral ligament repair for _____

Answer 50

posteromedial rotatory instability

Question 51

posteromedial rotatory instability technique

Answer 51

ORIF with buttress plate fixation or pins and lateral ligament repair

Question 52

post op rehab:

Answer 52

thermoplastic resting splint avoid shoulder abduction for 4-6 weeks early active motion

Question 53

thermoplastic resting splint:

Answer 53

applied with elbow at 90° and forearm in neutral restrict terminal 30° extension for 2-4 weeks

Question 54

thermoplastic resting splint: applied with elbow at 90° and forearm in neutral restrict terminal _____ for 2-4 weeks

Answer 54

30 degrees extension

Question 55

avoid shoulder abduction for 4-6 weeks to prevent ____ movement on arm

Answer 55

varus

Question 56

dynamic muscle contraction may improve gapping of the ____ joint after surgical repair

Answer 56

ulnohumeral

Question 57

ORIF with posterior approach technique

Answer 57

mobilize olecranon fracture to access coronoid fracture for associated olecranon fracture-dislocations repair coronoid fragment first prior to reducing main ulnar fracture olecranon ORIF with dorsal plate and screws

Question 58

complications:

Answer 58

Recurrent elbow instability Elbow stiffness Posttraumatic arthritis Heterotopic ossification Early failure