Correlation of radial head and coronoid process fractures in elbow trauma – a retrospective analysis of fracture patterns

While the relationship between radial head fractures (RHF) and coronoid process fractures (CPF) is biomechanically established, the exact frequency of CPF in RHF patients without focus on elbow dislocations is underexplored. To better estimate the likelihood of CPF, the analysis of typical fracture constellations is useful. The aim of this study was therefore to analyze the correlation between RHF severity and the presence and type of CPF. This retrospective study analyzed 356 RHF patients, evaluating the prevalence and correlation of CPF using CT and intraoperative data. Only cases with confirmed presence or absence of CPF based on CT imaging or surgical reports were included. CPF were classified according to O'Driscoll (OD) and correlated with the severity of the RHF according to Mason (MA). Descriptive statistics and correlation using Spearman correlation were performed. CPF was observed in 42.1 % of RHF patients. 51.3 % of CPF were OD Type 1, 26% Type 2 and 10.7% Type 3. The correlation between RHF severity and CPF presence was statistically significant but weak (Spearman r = 0.19). In this study cohort, a high proportion of additional CPF were found in the presence of RHF. Although the correlation was weak, increasing RHF severity was associated with a higher likelihood of CPF. These findings emphasize that in cases of RHF, the CP should be critically examined and CT imaging should be considered in unclear cases.