This study states that Anteromedial coronoid fractures (AMCFs) are associated with persistent elbow instability and post-traumatic arthritis if managed incorrectly. It is unclear exactly which AMCFs require surgical intervention and how to make this decision. The aims of this study were to report outcomes of AMCFs managed using a protocol based on reproduction of instability using radiographic and clinical testing and to ascertain a threshold size of AMCF associated with instability. Forty-three AMCFs were studied. Thirty-two patients formed the primary study group (group A). All were treated using a protocol in which the decision to perform coronoid fixation was based on the presence of radiographic or clinical evidence of instability. Functional outcomes (Oxford Elbow Score), radiographic outcomes, complications, and reoperations were collected, and a receiver operating characteristic curve analysis was performed to assess the optimal coronoid fracture height to recommend coronoid fixation. The results were compared with a historical group of 11 patients with AMCFs not treated according to the protocol (group B).

Of the patients, 23 had an isolated AMCF and 20 had a concurrent radial head injury.

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