Functional Outcome of Coronoid Process Fracture Fixed with Suture Anchors

Abstract

Introduction: Coronoid process fractures are a key determinant of elbow stability, especially in terrible triad injuries, where disruption of the anterior buttress leads to instability and functional impairment. Suture anchor fixation has gained importance in managing small and comminuted fragments by restoring capsuloligamentous integrity and enabling early mobilization.

Aim & Objective: To evaluate the functional outcome of coronoid process fractures fixed with suture anchors, with specific assessment of elbow stability, range of motion, HSS elbow score, and postoperative complications.

Materials & Methods: This observational follow-up study was conducted in the Department of Orthopaedics, Government Medical College, Kottayam, over 16 months after IRB approval. A total of 21 adult patients with terrible triad elbow and Regan Morrey type I and II coronoid fractures were included. All patients underwent coronoid fixation using suture anchors along with appropriate management of radial head fractures and lateral collateral ligament repair. Postoperative immobilization was maintained for two weeks, followed by structured rehabilitation. Patients were followed for six months and evaluated using the HSS elbow score.

Results: The mean flexion arc was 107°, the mean flexion contracture was 14°, and the mean rotational arc was 131°, indicating satisfactory restoration of motion. The majority of patients achieved functional forearm rotation, and 53% had minimal contracture (≤10°). HSS scoring showed 14% excellent, 62% good, 9.5% fair, 9.5% poor, and 4.8% failed outcomes, reflecting predominantly favorable recovery.

Conclusion: Suture anchor fixation of Regan Morrey type I and II coronoid fractures provide stable fixation, facilitates early mobilization, and results in good to excellent functional outcomes, supporting its effectiveness as a minimally invasive technique.