Coronoid Fracture Clinical Presentation

Updated: Oct 11, 2021
  • Author: Nirmal Tejwani, MD, MPA; Chief Editor: Murali Poduval, MBBS, MS, DNB  more...
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Presentation

History and Physical Examination

Coronoid fractures are usually seen in patients with elbow dislocations. The patient usually presents with a history of a fall on the outstretched hand and a deformity of the elbow.

The presence of an unstable reduction is suggestive of an associated coronoid or radial head fracture. An irreducible dislocation, on the other hand, should arouse suspicion of soft-tissue (brachialis, median nerve) or bony (medial epicondyle) interposition in the joint.

Distal vascularity and neurologic status should always be tested in these cases.

In children, coronoid fractures have a bimodal age distribution, with peaks at age 8-9 years and at age 12-14 years. [24]  Coronoid fractures in children are often associated with elbow dislocationsolecranon fracturesmedial epicondyle fractures, or lateral condyle fractures.

In children younger than 6 years, Blasier described an unusual flap injury of the unossified coronoid in which the elbow is dislocated and a small flap of the articular surface gets flipped back into the joint. [25]  This usually appears on the lateral radiograph as a small flake of bone in the anterior portion of the joint. This flake is a clue to the underlying pathoanatomy and the extent of injury.