Anteromedial coronoid facet fractures and associated ligament lesions: A case series.

• Fractures of the anteromedial facet of the coronoid require addressing as combined osteoligamentous injuries. • With a rupture rate of 91.7% in this cohort, the MCL appears to be more frequently affected than previously suggested. • The presented systematic algorithm might save the lateral approach through the medial start of the procedure in subtype 2 and 3 fractures of the anteromedial facet in certain cases. Varus posteromedial rotational injury mechanisms lead to fractures of the coronoids process' anteromedial facet. As these fractures are often unstable, rapid fracture treatment is vital to prevent progressive osteoarthritis. Twelve patients with a fracture of the anteromedial facet treated surgically were enrolled in the study. Computed tomography images were used to classify the fractures according to the system by O'Driscoll et al. Clinical follow-up included each patient's medical record, surgical treatment algorithm, all complications encountered during the follow-up period, Disabilities of the arm, shoulder, and hand score, subjective elbow value, and pain. A total of 8 men (66.7%) and 4 women (33.3%) were treated surgically and followed-up after a mean period of 45 ± 23 months. The mean DASH score was 11.9 ± 12.9 points. One patient complained of transient neuropathy in the innervation area of the ulnar nerve, however, this existed already pre-operatively and resolved after less than three months. The presented patient cohort shows that AMF fracture of the coronoid process are unstable lesions according to the bony instability and the frequently ruptured collateral ligament complexes which need to be addressed. The MCL seems to be affected more frequently than previously appreciated. Level IV; Case Series; Treatment Study. [ABSTRACT FROM AUTHOR]