Suture Button Fixation for Regan-Morrey Type II Coronoid Fracture of Anterior and Posterior Monteggia Fracture: A Report of Two Cases

This report details two cases of Monteggia fracture-dislocations that were successfully managed using the TightRope suture button technique via the posterior approach. The first case involved a 26-year-old man with type IID posterior Monteggia fracture-dislocation. Treatments included coronoid stabilization, radial head replacement, and variable-angle elbow plate placement. Seventeen months after the injury, his elbow motion ranged from 15° to 115°, with 50° supination and 10° pronation. In the second case, a 50-year-old woman with type IID anterior olecranon fracture-dislocation achieved elbow motion from 10° to 125° at 12 months after injury, with 80° supination and 70° pronation following similar fixation. Both patients underwent surgery using a global posterior approach. TightRope fixation was used for coronoid tip fragments, whereas locking plates were used for proximal ulnar and olecranon fractures. This method eliminates the need for an anterior incision and allows open reduction internal fixation through a single incision.