Good outcome using anatomically pre-formed buttress plates for anteromedial facet fractures of the coronoid-a retrospective study of twenty-four patients.

Abstract

The aims of this retrospective study were to describe the characteristics of anteromedial facet fracture of the coronoid (AMFF) and to determine the outcome following surgery using anatomically pre-formed coronoid buttress plates. Twenty-four patients underwent surgery for AMFF, using a pre-formed buttress plate, between 2011 and 2017 (20 men, four women), with a mean age of 47.7years (range, 19-78years) and a mean post-operative follow-up of 3.7years (range, 12-86months). Fracture classification, injury pattern, accompanying injuries, post-operative range of motion, and revision rate were noted. Post-operative radiographs assessed union, arthritic change, and joint articulation. Joint function was quantified using the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), and the Disabilities of the Arm, Shoulder, and Hand (DASH) scores. Eleven cases with subtype 2 and 13 cases with a subtype 3 AMFF could be included, of which 15 had an associated rupture of the lateral collateral ligament (LCL) and nine of the medial collateral ligament (MCL). Post-operatively, all cases went to bone union without secondary elbow instability. The mean post-operative range of motion was 125° (range, 90-140°), mean MEPS was 98, mean OES was 43, and mean DASH score was 7. Five patients required repeat surgery within two years due to a limited range of motion; 90% of patients regained their pre-trauma levels of physical activity. AMFF are challenging injuries, frequently associated with lesions to the collateral ligament complex. Using anatomically pre-formed coronoid plates, excellent functional outcomes can be achieved.