Arthroscopic Reduction and Fixation of Coronoid Fracture with Screws and Modified Pull Out Configuration

The coronoid process plays a crucial role in the stability of the elbow.When this process suffers a fracture, it is usually associated with other bone or ligament injuries that also play a central role in the stability of the elbow.1) For this reason, the main consensus is the stabilization of all coronoid fractures (CFs) associated with elbow instability.2) Due to the intra-articular location of the coronoid process, surgical stabilization can be a big challenge because great precision is required in the location of the needles to stabilize the fractured fragment, especially when no fracture of the radial head can facilitate visual exposure in the lateral approach.The advantages of using arthroscopy for fractures, such as less scarring, reduced bleeding, less postoperative pain, and reduced risk of infection, have increased the indication for arthroscopic reduction and internal fixation.3) In the case of CFs, arthroscopic reduction and internal fixation can help obtain better visualization and control of the anatomic reduction to restore elbow stability.Without the need for large incisions, it can prevent further damage to the anterior capsule and protect the blood supply to the fractured fragment.2,4) Our main objective is to describe the effectiveness of arthroscopy in obtaining adequate reduction and fixation of isolated CFs.This technique allows optimal stability of the fragment and early rehabilitation.This study was approved by the Ethics Committee of Clínica Indisa (2024), and written informed consent was obtained from the patient. TECHNIQUE Preoperative PositionThe patient received general anesthesia and interscalene block.A tourniquet was applied around the upper arm with the patient in the lateral decubitus position.The upper arm was supported by an arm holder attached to the side of the operating table.A standard 4-mm 30° arthroscope was routinely used.The entry points to the elbow were marked before inflating the tourniquet to 250 mmHg.The joint was insufflated with 80 mL of saline solution through the soft spot portal.