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. 2025 Jan;17(1):86-95.
doi: 10.1177/17585732241229636. Epub 2024 Feb 16.

Surgical outcomes and complication rates of arthroscopic-assisted fixation versus open fixation for coronoid fractures: A systematic review and meta-analysis

Erica Kholinne  1   2 , Hua Liu  3 , Leonard Christianto Singjie  4 , Maria Anastasia  4 , Jae-Man Kwak  5 , In-Ho Jeon  6
Affiliations

Surgical outcomes and complication rates of arthroscopic-assisted fixation versus open fixation for coronoid fractures: A systematic review and meta-analysis

Erica Kholinne et al. Shoulder Elbow. 2025 Jan.

Abstract

Background: Coronoid fractures often occur with complex elbow dislocations, accounting for 15% of elbow fractures. The effectiveness of open reduction internal fixation (ORIF) versus arthroscopic-assisted reduction internal fixation (ARIF) surgeries for coronoid fractures remains uncertain. This study aimed to compare the outcomes of these two surgical approaches in treating varus posteromedial injuries.

Methods: This study was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol was registered with PROSPERO. The primary outcomes assessed in this study were the functional outcomes measured by the Mayo Elbow Performance Score (MEPS) and the complications associated with each surgical approach.

Results: Analysis of the data from 759 patients included in this study revealed that the mean postoperative MEPS score was higher in the ARIF group compared to the ORIF group (97.5 Vs. 90.7), with the mean improvement in MEPS was 16.6 points (19 for ORIF and 14.3 for ARIF). The complication rate in the ORIF group was 24.6%, while the ARIF group reported a complication rate of 6%.

Conclusion: This study suggests that ARIF surgery can yield comparable and promising outcomes to ORIF surgery for coronoid fractures.

Level of evidence: IV.

Keywords: coronoid; coronoid fracture; elbow arthroscopy; elbow dislocation; elbow instability.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow chart. PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2.
Figure 2.
Distribution of MINORS scores and the range of studies considered high quality. MINORS: methodologic index for non-randomized studies.
Figure 3.
Figure 3.
The Mayo Elbow Performance Score (MEPS) of ARIF group. ARIF: arthroscopic-assisted reduction internal fixation.
Figure 4.
Figure 4.
The Mayo Elbow Performance Score (MEPS) of the ORIF group. ORIF: open reduction internal fixation.
See this image and copyright information in PMC

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