Pull Out Suture Technique for Fixing Coronoid Fractures using a Single Lateral Extensor Digitorum Communis Split Approach and Fiberwire Endobutton Fixation by Retrograde Drilling - A Case Series.

INTRODUCTION: Coronoid fractures, while less common than other elbow injuries, present with significant challenges in maintaining elbow stability and function. Restoring the normal anatomy of the coronoid process (CP) is crucial for stabilizing the elbow joint, with surgical intervention often necessary for displaced or comminuted fractures. Suture button fixation offers advantages, such as ease of use, bone-sparing fixation, and reduced reliance on intraoperative X-rays. It is especially effective for small or fragmented fractures, with tools, such as aiming devices and repositioning pliers aiding in accurate fragment alignment. In this study, we present a novel technique that was used in six patients at our institute, involving the use of FiberWire and an Endobutton, approached through a single lateral split of the extensor digitorum communis.

MATERIALS AND METHODS: Six patients from our institute, which is a tertiary care hospital, who underwent the procedure between May 2022 and July 2025, were followed for 1 year. Functional outcomes were assessed using the Mayo Elbow Performance Index and Disabilities of the Arm, Shoulder, and Hand score.

RESULTS: Type 1 coronoid fractures fixed in this study resulted in early mobilization. The elbow joint was stable with a satisfactory functional arc. Repairing the anterior capsule and the damaged CP tip results in a more stable elbow, and fixing the associated fractured radial head and employing the suspensory action of an endobutton in type 1 and type 2 CP fractures produce positive results and a prompt return to activity. Comminuted fractures that are difficult to stabilize using a suture loop anchor can be treated with endobutton fixation.

CONCLUSION: Coronoid fracture fixation using this technique provides a reliable fixation for Type 1 and Type 2 fractures with the advantages of minimal soft tissue disruption, strong fixation, and early mobilization. It can be considered a promising option in the surgical management of coronoid fractures.