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Mandibular coronoid process hyperplasia is a rare developmental condition. It commonly presents with progressive restriction of mouth opening, due to the impingement of the enlarged and elongated coronoid process on the distal aspect of the zygomatic arch during mandibular movement. It may present unilaterally or bilaterally. Surgical intervention to improve opening is advocated in cases with significant functional impairment, followed by post-operative physiotherapy. A case of bilateral coronoid process hyperplasia in a 28-year-old man treated with bilateral coronoidectomy, with subsequent post-operative relapse in degree of opening successfully treated via manipulation under intravenous sedation is presented. [ABSTRACT FROM AUTHOR]

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Lengthening temporalis myoplasty (LTM), first described by Labbé in 1997, ensures the transfers of the entire temporal muscle from the coronoid process to the upper half of the lip without interposition of aponeurotic tissue. The temporal muscle changes function because it is entirely mobilized toward another effector: the labial commissure. Thanks to brain plasticity, the muscle loses its chewing function, and after 6 months of speech rehabilitation it acquires its new smiling function. We describe technical points especially the coronoid process approaches both through an upper temporal fossa approach and a lower nasolabial fold approach. Rehabilitation starts 3 weeks after the surgery following a standardized protocol to move from a mandibular smile to a voluntary, then spontaneous, smile in three steps. The LTM is the main part of a one-stage global treatment of the paralyzed face. It constitutes a dynamic palliative treatment usually started at the sequelae stage, 18 month after the outcome of a peripheral facial paralysis. This one-stage procedure is a reproducible and relevant surgical technique in the difficult treatment of peripheral facial paralysis. It allows implementing an active muscle transfer to reanimate the labial commissure and recreate a mobile nasolabial fold. [ABSTRACT FROM AUTHOR]

Objective: Terrible triad injury of the elbow (TTIE), comprising elbow dislocation with radial head and coronoid process fracture, is notoriously challenging to treat and has typically been associated with complications and poor outcomes. The objective of this systematic review was to summarize the most recent available evidence regarding functional outcomes and complications following surgical management of TTIE. Methods: Medline, EMBASE, Cochrane Library, and Google Scholar were searched to identify relevant studies, which were included if they were retrospective or prospective in design, involved participants who had TTIE, and were published in English. Outcomes of interest were functional outcomes and complications. Results: Sixteen studies, involving 312 patients, were included in the systematic review. Mean follow up after surgery was typically 25 to 30 months. Mean Mayo elbow performance scores ranged from 78 to 95. Mean Broberg-Morrey scores ranged from 76 to 90. Mean DASH scores ranged from 9 to 31. The proportion of patients who required reoperation due to complications ranged from 0 to 54.5% (overall  = 70/312 [22.4%]). Most of these complications were related to hardware fixation problems, joint stiffness, joint instability, and ulnar neuropathy. The most common complications that did not require reoperation were heterotopic ossification (39/312 [12.5%] patients) and arthrosis (35/312 [11.2%] patients). Conclusions: The results of this systematic review indicate that functional outcomes after surgery for TTIE are generally satisfactory and that complications are common. Further research is warranted to determine which surgical techniques optimize functional outcomes and reduce the risk of complications. [ABSTRACT FROM AUTHOR]

Background: Autograft reconstruction of the coronoid using the tip of the olecranon has been described as a treatment option for comminuted coronoid fractures or coronoid nonunions that are not repairable. The purpose of this in vitro biomechanical study of the coronoid-deficient elbow was to determine whether coronoid reconstruction using the tip of the ipsilateral olecranon would restore elbow kinematics. Methods: An elbow motion simulator was used to perform active and passive extension of six cadaveric arms in the horizontal, valgus, varus, and vertical orientations. Elbow kinematics were quantified with use of the screw displacement axis of the ulna with respect to the humerus. Testing was performed with an intact coronoid, a 40% coronoid deficiency, and a coronoid reconstruction using the tip of the ipsilateral olecranon. Results: Creation of a 40% coronoid deficiency resulted in significant changes (range, 3.6° to 10.9°) in the angular deviations of the screw displacement axis relative to the intact state during simulated active and passive extension in the varus orientation with the forearm in pronation and in supination (p < 0.05). Reconstruction of the coronoid using the ipsilateral olecranon tip restored the angular deviations to those in the intact state (p > 0.05) with the arm in all orientations except valgus, in which there was a small but significant difference (0.4° ± 0.2°, p = 0.04) during passive motion with forearm supination. Conclusions: Reconstruction of the coronoid using the tip of the ipsilateral olecranon was an effective method for restoring normal kinematics over a range of elbow motion from 20° to 120° in a cadaveric model of an elbow with a 40% coronoid deficiency. This reconstruction technique may prove beneficial for patients with elbow instability due to coronoid deficiency. Clinical Relevance: This study supports the biomechanical concept of coronoid reconstruction using the ipsilateral olecranon tip for coronoid fractures or nonunions involving 40% of the coronoid process. [ABSTRACT FROM AUTHOR]

Purpose: The aim was to provide anatomical data for local blocking treatment of de Quervain's disease through investigating features and classification of the first extensor groove on the radial styloid process. Methods: Two hundred and eighty-four specimens of the intact distal extremity of dry radii from Chinese corpses were investigated and measured systematically in this study. Morphological features of the extensor grooves on the radial styloid process were observed by visual inspection. Correlation parameters of variability were measured with a vernier caliper. Results: The study showed that the most prevalent group was Type I (the extensor groove that was deep and divided into two sub-grooves by a tiny bony ridge) accounting for 63.73 % (181 specimens). Seventy-nine specimens belonged to Type II (the extensor groove without the tiny bony ridge) accounting for 27.82 % and 24 specimens belonged to Type III (almost without any extensor groove on the radius) accounting for 8.45 %. The distance between the processus of the palmar bony ridge and the processus of the dorsal bony ridge (defined as AC) was 11.55 ± 1.32 mm. The distance between the processus of the palmar bony ridge and the sharp point of the styloid process of the radius (defined as AB) was 17.09 ± 1.99 mm. Conclusions: The extensor groove could provide a subjective safe operation range for the steroid injections, which could be defined depending on the bony landmarks, which are easy to identify in the body surface. This anatomical variation is important in the management of de Quervain's disease. [ABSTRACT FROM AUTHOR]

The article discusses the treatment for triad elbow fracture-dislocation with a systematic approach includes its fixation on the coronoid using the lasso technique. It notes on the three critical aspects which describes the fracture-dislocations of the elbow includes coronoid fracture, posterior elbow dislocation and radial head fracture. It also mentions that elbows treated with coronoid suture lasso technique has lower rate of complications including malunion, hardware failure and nounion.

We investigated a minimally invasive anterior approach to reduce and fix coronoid fractures with a screw in eight consecutive patients and evaluated seven patients at a minimum of 1 year (mean, 78 weeks; range, 61–89 weeks). It was only possible to repair seven of eight coronoid fractures. The average time to radiographic healing was 12 weeks and all healed without the screw loosening, migration or breakage. Endoscopy permitted an excellent view of coronoid fractures, allowing anatomic fixation, and as it avoided extensive soft tissue dissection, this method preserved soft tissue attachments of small coronoid fragments. This method was safe and minimally invasive. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the clinical effect of joint reconstruction by using autogenous coronoid process graft to treat temporomandibular joint (TMJ) ankylosis. METHODS: Nine cases of TMJ ankylosis from September 2008 to September 2010 were surgically treated by joint reconstruction with autogenous coronoid process graft, using autogenous articular disc or prosthodontic membrane as interpositional material. Mouth opening, occlusion and cone beam CT(CBCT) were used for evaluation before and after surgery. RESULTS: Satisfactory mouth opening was achieved in all patients and no one got occlusal changes or reankylosis during follow-up. CBCT showed that coronoid process graft reached bone union with the ramus and turned to be round. CONCLUSIONS: It is effective to cure TMJ ankylosis through joint reconstruction with autogenous coronoid process graft. [ABSTRACT FROM AUTHOR]

An unusual accidental displacement of a mandibular third molar crown into the parapharayngeal space in an adult female patient is reported. In combination with clinical examination, conventional and advanced radiographic techniques were utilised in order to locate the crown for retrieval surgery. Under general anaesthesia, an incision starting from buccal sulcus towards distobuccal angle of the second molar at gingival margin was extended to the coronoid process. The dislodged crown was found by means of blunt dissection and grasped with a pair of artery forceps and removed. [ABSTRACT FROM AUTHOR]