The anterior elbow capsule attaches to the anterior coronoid process at its base, providing the anterior capsular ligamentous restraint for the ulnohumeral joint at the coronoid level.
The anterior capsule-coronoid attachment resists hyperextension and anterior joint distraction, contributes to anterior stability with the anterior band UCL, and is disrupted in anterior coronoid shear fractures.
Coronoid fractures are classified by the O'Driscoll system — Type I (tip avulsion from anterior capsule pull), Type II (anteromedial coronoid), Type III (basal fractures). The terrible triad injury (elbow dislocation + radial head + coronoid fractures) disrupts the anterior capsular attachment along with the lateral ligament complex.
Anterior capsule pull-off of the coronoid tip in elbow dislocation, producing a small fragment that requires fixation only when associated with persistent instability.
Elbow dislocation with radial head and coronoid fractures disrupting the anterior capsular attachment, requiring fixation of all three components to restore elbow stability.
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