The coronoid process is the anteriorly projecting bony prominence of the proximal ulna that forms the anterior boundary of the trochlear notch, the distal articular surface of the humeroulnar joint. Its tip and anterolateral facet are the primary bony restraints to posterior elbow dislocation.
Coronoid fractures are classified by the O'Brien system (tip, anteromedial facet, basal) and the Regan-Morrey system (height of fracture). Anteromedial facet fractures are associated with varus posteromedial rotatory instability. Tip fractures occur in simple elbow dislocations. The terrible triad (elbow dislocation + radial head fracture + coronoid fracture) requires reconstruction of all three components for elbow stability.
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