To evaluate the clinical efficacy and complications of arthroscopic tension band wiring with Kirschner wires for coronoid process fractures combined with mini-incision repair of lateral collateral ligament injuries in the treatment of varus posteromedial rotatory instability (VPMRI) of the elbow.

This was a retrospective case-control study. Between March 2019 and September 2022, a total of 20 patients with cubitusvarus and posteromedial rotatory instability who were treated at Xuzhou Renci Hospital were enrolled. Patients with pre-existing elbow stiffness were excluded. The cohort comprised nine males and 11 females, with four left and 16 right elbow injuries. All the patients underwent arthroscopic Kirschner wire tension band fixation for the coronoid fracture combined with a small-incision repair of the lateral collateral ligament injury.Observation indicators included operation time, intraoperative blood loss, elbow range of motion (flexion, extension, internal rotation, external rotation), the visual analogue scale (VAS) for pain, and the Mayo elbow performance score (MEPS). Complications (heterotopic ossification, joint stiffness, nerve injury, skin irritation), patient satisfaction, and fracture healing were recorded. Paired t tests were used for statistical comparisons.

All the patients were followed up for (16±5) months. The mean age was (30±12) years. The mean operation time was (85±11) min, and the mean intraoperative blood loss was (56±10) ml. At the final follow-up, the elbow range of motion [flexion (137.3±8.6)°, extension (-1.5±2.8)°, internal rotation (84.3±5.3)°, external rotation (82.3±8.3)°] showed significant improvement compared to preoperative values [(61.3±10.1)°, (-16.5±7.5)°, (43.1±9.8)°, (40.3±6.5)°] (t=25.622, 8.379, 16.538, 17.817, all P<0.05). The final MEPS was 97±4 significantly higher than the preoperative score of 42±7 (t=30.509, P=0.001). The final VAS score was 1.3±0.6, significantly lower than the preoperative score of 7.1±1.3 (t=18.116, P=0.001).

Although arthroscopic tension band fixation of coronoid fractures combined with mini-open lateral collateral ligament repair for VPMRI is technically demanding, it allows early postoperative rehabilitation and reduces complications.