Universität zu Köln

Lanzerath, Fabian ORCID: 0000-0002-4780-6875, Hackl, Michael, Wegmann, Kilian, Mueller, Lars Peter and Leschinger, Tim (2022). Conservative treatment of fractures involving the coronoid process Systematic review of indication algorithms, treatment protocols, outcomes, and complications. Obere Extremitaet-Schulter-Ellenbogen-Hand, 17 (3). S. 180 - 189. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1862-6602

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Abstract

Background Fractures of the coronoid process require adequate treatment, as otherwise they often lead to chronic instability and the development of rapidly progressive cubital osteoarthritis. Commonly, such patients are treated surgically; however, a defined fraction of patients might benefit from conservative treatment. Methods We systematically reviewed the available literature searching Medline using the PubMed interface. The primary objective was to determine indications, treatment protocols, and associated functional outcomes and complications of entirely conservatively treated fractures of the coronoid. The PRISMA guidelines were applied. Results We included five studies, all retrospective in design, with a total of 62 patients. For the indication of conservative treatment, joint congruency on imaging was a prerequisite in all studies. This was supplemented on most occasions by dynamic clinical examinations, with a focus on pain, range of motion, and adequate joint stability. Treatment protocols included close-meshed imaging, early functional mobilization, and some form of resting immobilization. Treatment success, defined as excellent or good results according to the Mayo Elbow Performance Score, was 95.1% at an average follow-up of 36 months. Six patients (9.7%) underwent surgical treatment during follow-up; 19 patients (30.6%) suffered complications that did not result in surgery. Conclusion The data of this work indicate that most patients achieve satisfactory results following conservative treatment of coronoid fractures caused by rotational moments. Concentric reduction of the joint, clinical exclusion of even mild subluxations, systematic early functional aftercare, and close radiographic monitoring appear to be mandatory requirements. The evidence remains scarce, and conclusions drawn from this review should be viewed with caution, as prospective randomized controlled trials are not available to date.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lanzerath, Fabian UNSPECIFIED orcid.org/0000-0002-4780-6875 UNSPECIFIED Hackl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-660348
DOI:	10.1007/s11678-022-00692-x
Journal or Publication Title:	Obere Extremitaet-Schulter-Ellenbogen-Hand
Volume:	17
Number:	3
Page Range:	S. 180 - 189
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1862-6602
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TERRIBLE TRIAD INJURIES; ANTEROMEDIAL FACET; ELBOW; MANAGEMENT; STABILITY Multiple languages Orthopedics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66034