Clinical and radiographic outcomes of coronoid fractures in children with or without elbow dislocation.
TL;DR
Pediatric coronoid fractures, although rare, can be successfully managed with individualized treatment plans and favorable outcomes were achieved with both conservative and surgical treatments, which were selected according to fracture morphology and elbow stability.
Abstract
Background Coronoid process fractures are uncommon injuries in the pediatric population, accounting for less than 2% of all elbow traumas. These lesions represent a diagnostic and therapeutic challenge due to their rarity and frequent association with elbow dislocation. The aim of this study is to analyze the management strategies for pediatric coronoid fractures and to present a case series of 11 patients with satisfactory clinical and functional outcomes. Methods This retrospective study reviewed 11 pediatric patients (mean age: 10.27 years; range: 5-13) treated for coronoid process fractures, with or without associated elbow dislocation, across two hospitals in northern Italy between January 2011 and December 2023. After applying inclusion criteria, all 11 patients were evaluated clinically and radiographically with a minimum follow-up of 12 months and then included in the study. Treatment strategy-conservative or surgical-was determined based on fracture morphology and associated injuries. Outcome measures included radiographic healing, range of motion, complications, and QuickDASH score. Results Seven cases (64%) involved elbow dislocation. Conservative treatment was employed in 8 patients (73%), while 3 underwent surgical fixation. At a mean follow-up of 8.45 years, the mean QuickDASH score was 3.3, indicating excellent functional outcomes. At the last follow-up visit, the patients all had full elbow ROM. Radiographic healing was observed in all patients, with no cases of nonunion or secondary displacement. Only one asymptomatic ossification was reported. Conclusion Pediatric coronoid fractures, although rare, can be successfully managed with individualized treatment plans. Favorable outcomes were achieved with both conservative and surgical treatments, which were selected according to fracture morphology and elbow stability. These treatments had low complication rates and yielded good long-term functional results. Loe IV.