Developmental trajectories of achievement emotions in mathematics during adolescence.

This study examined how adolescents' emotions in mathematics develop over time. Growth curve modeling was applied to longitudinal data collected annually from 2002 to 2006 (Grades 5-9; N = 3425 German adolescents; Mage = 11.7, 15.6 years at the first and last waves, respectively; 50.0% female). Results indicated that enjoyment and pride decreased over time (Glass's Δs = -.86, -.71). In contrast, negative emotions exhibited more complex patterns: Anger, boredom, and hopelessness increased (Δs = .52, .79, .26), shame decreased (Δ = -.12), and anxiety remained stable (Δ = .00). These change trajectories of emotions were associated with change trajectories of perceived control, intrinsic value, achievement value, and achievement in mathematics. Implications and future directions are discussed.

Our individual order of things directs how we think we feel.

ABSTRACTOur work draws upon Foucault's idea that the order of things, defined as the way we categorise our world, matters for how we think about the world and ourselves. Specifically, and drawing upon Pekrun's control-value theory, we focus on the question of whether the way we individually order our world into categories influences how we think about our typically experienced emotions related to these categories. To investigate this phenomenon, we used a globally accessible example, namely, the categorisation of knowledge based on school subjects. In a longitudinal sample of high school students (grades 9-11), we found that judging academic domains as similar led to judging typical emotions related to those domains as more similar than experienced in real life (assessed via real-time assessment of emotions). Our study thus shows that the order of things matters in how we think we feel with respect to those things.

Safe Drill Trajectory for Anatomic Repair of Distal Biceps Tendon Through a Single Incision: A Cadaveric Study.

PURPOSE: We sought to determine the safest drill trajectory to avoid injury to the posterior interosseous nerve (PIN) when performing a repair of a distal biceps tendon to an anatomic location through an anterior, single-incision approach using cortical button fixation. METHODS: A standard anterior approach was performed in 10 cadaveric specimens to expose the distal biceps attachment. Three drill holes were made in the radial tuberosity from the center of the anatomic footprint for the distal biceps tendon insertion with the forearm fully supinated. Holes were made in 30° distal, transverse, and 30° proximal directions. Each hole was made by angling the trajectory from an anterior to posterior and ulnar to radial direction, leaving adequate bone on the ulnar side to accommodate an 8-mm tunnel for the purpose of docking the biceps tendon into bone. The proximity of each drill trajectory to the PIN was determined by making a second incision on the dorsum of the proximal forearm. A K-wire was passed through each hole, and the distance between the PIN and K-wire was measured for each trajectory. RESULTS: The distally directed drill hole placed the trajectory wire closest to the PIN (mean distance, 5.4 mm), contacting the K-wire in 3 cases. The transverse drill trajectory resulted in contact with the PIN in 1 case (mean distance, 7.6 mm). The proximal drill trajectory appeared safest, with no PIN contact (mean distance, 13.3 mm). CONCLUSIONS: In this cadaveric study, the proximal drill trajectory resulted in the widest clearance from the PIN. CLINICAL RELEVANCE: When performing repair of a distal biceps tendon to the anatomic location on the tuberosity, the drill trajectory from the center of the biceps footprint should be radial and proximal to provide the greatest separation between the drill guide and the PIN.

Radial artery aneurysm secondary to dynamic entrapment by extensor pollicis longus tendon: a case of snapping thumb.

Aneurysms of the distal radial artery at the level of the wrist are rare. Most reported cases are posttraumatic, either from iatrogenic arterial puncture for radial arterial access or from a penetrating injury. Other causes include infection and connective tissue disorders. Early diagnosis is important to avoid the potential complications of thrombus formation, distal digital ischemia, and rupture. Evaluation of the radial artery is typically performed using non-invasive modalities like ultrasonography, computed tomographic angiography (CTA), and magnetic resonance angiography (MRA). Invasive angiography can also be performed, particularly if minimally invasive treatment options are being considered. We report a case of a 35-year-old male mechanic who presented with pain at the base of the left thumb dorsally, with reproducible painful snapping on dynamic exam. Ultrasound demonstrated a fusiform aneurysm of the radial artery. At the level of the aneurysm, there was dynamic entrapment of the artery between the extensor pollicis longus (EPL) tendon and the underlying trapezium. The patient's symptoms improved with conservative management and avoidance of the snapping-producing maneuvers. To our knowledge, this is the first published case of snapping at the base of the thumb resulting in repetitive entrapment of the radial artery by the EPL tendon captured on dynamic ultrasound examination.

Supination torque following single- versus double-incision repair of acute distal biceps tendon ruptures.

BACKGROUND: Compared with single-incision (SI) distal biceps repair, double-incision (DI) repair has been described as permitting a more anatomic repair. We hypothesized that DI repair would result in greater terminal supination torque compared with SI repair for acute distal biceps ruptures. METHODS: Patients were included if they sustained an isolated, acute distal biceps rupture repaired between January 2012 and December 2017. Isometric forearm supination torque in 4 positions was measured using a validated uniaxial torque-testing device. Testing took place at least 12 months from surgery. The primary outcome was supination torque in the 60° supinated position. Secondary outcomes included supination torque in other forearm positions and functional outcome scores. RESULTS: The study included 37 patients: 15 underwent repair with the DI technique and 22 with the SI technique. The mean age was 47.3 years, the median follow-up time was 28.1 months, and demographic data were similar between cohorts. Mean supination torque, relative to the unaffected side, was 61% (95% confidence interval, 45%-77%) for DI repair vs. 80% (95% confidence interval, 69%-92%) for SI repair in the 60° supinated position (P = .036). In a multivariable linear regression model controlling for arm dominance, age, follow-up time, and workers' compensation status; SI repair was associated with greater mean supination torque than DI repair by 20% (P = .015). CONCLUSIONS: Contrary to our hypothesis, we found a 20% mean improvement in terminal supination torque for acute distal biceps ruptures repaired with the SI technique compared with the DI technique. This finding may have clinical significance for the more discerning, high-demand patient.

Long-term outcomes of total elbow arthroplasty for distal humeral fracture: results from a prior randomized clinical trial.

BACKGROUND: Total elbow arthroplasty (TEA) is a reliable treatment for elderly patients with comminuted intra-articular distal humeral fractures. However, the longevity and long-term complications associated with this procedure are unknown. The objectives of this study were to examine long-term outcomes and implant survival in elderly patients undergoing TEA for fracture. METHODS: Patients from a previously published randomized controlled trial of 42 patients in which TEA was compared with open reduction-internal fixation (ORIF) were followed up long term. Patients were aged 65 years or older with comminuted intra-articular distal humeral fractures. Outcomes included patient-reported grading of function and pain, revision surgical procedures, and implant survival. RESULTS: Data were obtained for 40 patients, 15 treated with ORIF and 25 treated with TEA, with a mean follow-up period of 12.5 years for surviving patients and 7.7 years for deceased patients. The reoperation rate was 3 of 25 in the TEA group and 4 of 15 in the ORIF group (P = .39). Of the 25 patients with TEAs, only 1 required (early) revision arthroplasty; 7 were living with their original arthroplasty, and 15 died with a well-functioning implant in situ. Three were lost to follow-up. CONCLUSIONS: TEA is an effective and reliable procedure for the treatment of comminuted distal humeral fractures in the elderly patient. Our study reveals reliable implant long-term survival, with no patient requiring a late revision. For the majority of these patients, a well-performed TEA will give them a well-functioning elbow for life and will be the last elbow procedure required.

Deep brain stimulation during early adolescence prevents microglial alterations in a model of maternal immune activation.

In recent years schizophrenia has been recognized as a neurodevelopmental disorder likely involving a perinatal insult progressively affecting brain development. The poly I:C maternal immune activation (MIA) rodent model is considered as a neurodevelopmental model of schizophrenia. Using this model we and others demonstrated the association between neuroinflammation in the form of altered microglia and a schizophrenia-like endophenotype. Therapeutic intervention using the anti-inflammatory drug minocycline affected altered microglia activation and was successful in the adult offspring. However, less is known about the effect of preventive therapeutic strategies on microglia properties. Previously we found that deep brain stimulation of the medial prefrontal cortex applied pre-symptomatically to adolescence MIA rats prevented the manifestation of behavioral and structural deficits in adult rats. We here studied the effects of deep brain stimulation during adolescence on microglia properties in adulthood. We found that in the hippocampus and nucleus accumbens, but not in the medial prefrontal cortex, microglial density and soma size were increased in MIA rats. Pro-inflammatory cytokine mRNA was unchanged in all brain areas before and after implantation and stimulation. Stimulation of either the medial prefrontal cortex or the nucleus accumbens normalized microglia density and soma size in main projection areas including the hippocampus and in the area around the electrode implantation. We conclude that in parallel to an alleviation of the symptoms in the rat MIA model, deep brain stimulation has the potential to prevent the neuroinflammatory component in this disease.

Achievement Emotions and Academic Performance: Longitudinal Models of Reciprocal Effects.

A reciprocal effects model linking emotion and achievement over time is proposed. The model was tested using five annual waves of the Project for the Analysis of Learning and Achievement in Mathematics (PALMA) longitudinal study, which investigated adolescents' development in mathematics (Grades 5-9; N = 3,425 German students; mean starting age = 11.7 years; representative sample). Structural equation modeling showed that positive emotions (enjoyment, pride) positively predicted subsequent achievement (math end-of-the-year grades and test scores), and that achievement positively predicted these emotions, controlling for students' gender, intelligence, and family socioeconomic status. Negative emotions (anger, anxiety, shame, boredom, hopelessness) negatively predicted achievement, and achievement negatively predicted these emotions. The findings were robust across waves, achievement indicators, and school tracks, highlighting the importance of emotions for students' achievement and of achievement for the development of emotions.

Minocycline rescues decrease in neurogenesis, increase in microglia cytokines and deficits in sensorimotor gating in an animal model of schizophrenia.

Adult neurogenesis in the hippocampus is impaired in schizophrenic patients and in an animal model of schizophrenia. Amongst a plethora of regulators, the immune system has been shown repeatedly to strongly modulate neurogenesis under physiological and pathological conditions. It is well accepted, that schizophrenic patients have an aberrant peripheral immune status, which is also reflected in the animal model. The microglia as the intrinsic immune competent cells of the brain have recently come into focus as possible therapeutic targets in schizophrenia. We here used a maternal immune stimulation rodent model of schizophrenia in which polyinosinic-polycytidilic acid (Poly I:C) was injected into pregnant rats to mimic an anti-viral immune response. We identified microglia IL-1ß and TNF-α increase constituting the factors correlating best with decreases in net-neurogenesis and impairment in pre-pulse inhibition of a startle response in the Poly I:C model. Treatment with the antibiotic minocycline (3mg/kg/day) normalized microglial cytokine production in the hippocampus and rescued neurogenesis and behavior. We could also show that enhanced microglial TNF-α and IL-1ß production in the hippocampus was accompanied by a decrease in the pro-proliferative TNFR2 receptor expression on neuronal progenitor cells, which could be attenuated by minocycline. These findings strongly support the idea to use anti-inflammatory drugs to target microglia activation as an adjunctive therapy in schizophrenic patients.

High-speed burr debulking of digital calcinosis cutis in scleroderma patients.

PURPOSE: To evaluate the functional outcome after removal of digital calcinosis cutis in patients with scleroderma using a high-speed burr. METHODS: A retrospective analysis was performed of 9 consecutively enrolled scleroderma patients who underwent surgery by the senior author. A debulking procedure using a high-speed micro-burr to soften and express calcific material in digits was performed. Demographics, complications, recurrence, and postoperative functional outcome measurements including the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Michigan Hand Questionnaire, a study-specific questionnaire, a visual analog scale, and the Short Form-12 were collected. RESULTS: Mean follow-up time was 2 years. Four of 9 patients were very or somewhat satisfied with the procedure. Eight complications were recorded in 6 patients, including weakness, decreased motion, numbness, and superficial wound infection. The mean Disabilities of the Arm, Shoulder, and Hand score in patients who would have surgery again was 27 (4 of 9), versus 54 (5 of 9) for those who would not. Two patients had no recurrence. There were 7 cases of recurrence; 3 patients had late recurrence to a small degree, 3 had early complete recurrence, and 1 had recurrence at an unknown onset. No patient reported complete resolution of calcinosis. Patient satisfaction appeared inversely correlated to the number of digits involved. CONCLUSIONS: Patients with discrete areas of calcinosis cutis, including those with 1 or 2 digits affected, did much better than patients with diffuse disease and multiple affected digits. Patients should be counseled that the benefit might be more limited than previously reported, and recurrence is likely. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Boredom due to being over- or under-challenged in mathematics: A latent profile analysis.

BACKGROUND: Recent research on boredom suggests that it can emerge in situations characterized by over- and under-challenge. In learning contexts, this implies that high boredom may be experienced both by low- and high-achieving students. AIMS: This research aimed to explore the existence and prevalence of boredom due to being over- and under-challenged in mathematics, for which empirical evidence is lacking. SAMPLE: We employed a sample of 1.407 students (fifth to ninth graders) from all three secondary school tracks (lower, middle and upper) in Bavaria (Germany). METHODS: Boredom was assessed via self-report and achievement via a standardized mathematics test. We used latent profile analysis to identify groups characterized by different levels of boredom and achievement, and we additionally examined gender and school track as group membership predictors. RESULTS: Results revealed four distinct groups, of which two showed considerably high boredom. One was coupled with low achievement on the test (i.e. 'over-challenged group', 13% of the total sample), and one was coupled with high achievement (i.e. 'under-challenged group', 21%). Furthermore, we found a low boredom and high achievement (i.e. 'well-off group', 27%) and a relatively low boredom low achievement group (i.e. 'indifferent group', 39%). Girls were overrepresented in the over-challenged group, and students from the upper school track were underrepresented in the under-challenged group. CONCLUSION: Our research emphasizes the need to openly discuss and further investigate boredom due to being over- and under-challenged.

The effect of a startle-eliciting device on the foraging success of individual harbor seals (Phoca vitulina).

Pinniped predation on commercially and ecologically important prey has been a source of conflict for centuries. In the Salish Sea, harbor seals (Phoca vitulina) are suspected of impeding the recovery of culturally and ecologically critical Pacific salmon (Oncorhynchus spp.). In Fall 2020, a novel deterrent called Targeted Acoustic Startle Technology (TAST) was deployed at Whatcom Creek to deter harbor seals from preying on fall runs of hatchery chum (O. keta) and Chinook (O. tshawytscha) salmon in Bellingham, Washington, USA. Field observations were conducted in 2020 to compare the presence and foraging success of individual harbor seals across sound exposure (TAST-on) and control (TAST-off) conditions. Observations conducted the previous (2019) and following (2021) years were used to compare the effects observed in 2020 to two control years. Using photo-identification, individual seals were associated with foraging successes across all 3 years of the study. Generalized linear mixed models showed a significant 45.6% reduction in the duration (min) individuals remained at the creek with TAST on, and a significant 43.8% reduction in the overall foraging success of individuals. However, the observed effect of TAST varied across individual seals. Seals that were observed regularly within one season were more likely to return the year after, regardless of TAST treatment. Generalized linear models showed interannual variation in the number of seals present and salmon consumed. However, the effect of TAST in 2020 was greater than the observed variation across years. Our analyses suggest TAST can be an effective tool for managing pinniped predation, although alternate strategies such as deploying TAST longer-term and using multi-unit setups to increase coverage could help strengthen its effects. Future studies should further examine the individual variability found in this study.

Do girls really experience more anxiety in mathematics?

Two studies were conducted to examine gender differences in trait (habitual) versus state (momentary) mathematics anxiety in a sample of students (Study 1: N = 584; Study 2: N = 111). For trait math anxiety, the findings of both studies replicated previous research showing that female students report higher levels of anxiety than do male students. However, no gender differences were observed for state anxiety, as assessed using experience-sampling methods while students took a math test (Study 1) and attended math classes (Study 2). The discrepant findings for trait versus state math anxiety were partly accounted for by students' beliefs about their competence in mathematics, with female students reporting lower perceived competence than male students despite having the same average grades in math. Implications for educational practices and the assessment of anxiety are discussed.

Sports and exercise-related tendinopathies: a review of selected topical issues by participants of the second International Scientific Tendinopathy Symposium (ISTS) Vancouver 2012.

In September 2010, the first International Scientific Tendinopathy Symposium (ISTS) was held in Umeå, Sweden, to establish a forum for original scientific and clinical insights in this growing field of clinical research and practice. The second ISTS was organised by the same group and held in Vancouver, Canada, in September 2012. This symposium was preceded by a round-table meeting in which the participants engaged in focused discussions, resulting in the following overview of tendinopathy clinical and research issues. This paper is a narrative review and summary developed during and after the second ISTS. The document is designed to highlight some key issues raised at ISTS 2012, and to integrate them into a shared conceptual framework. It should be considered an update and a signposting document rather than a comprehensive review. The document is developed for use by physiotherapists, physicians, athletic trainers, massage therapists and other health professionals as well as team coaches and strength/conditioning managers involved in care of sportspeople or workers with tendinopathy.

Functional results following vascularized versus nonvascularized bone grafts for wrist arthrodesis following excision of giant cell tumors.

PURPOSE: Wrist arthrodesis after resection of a giant cell tumor of the distal radius can be performed using a vascularized free fibular transfer (VFFT) or a nonvascularized structural iliac crest transfer (NICT). The purpose of this study was to compare the union times, functional outcomes, and complications after these procedures. METHODS: We identified 27 patients at 2 centers: 14 underwent VFFT, and 13 NICT. The 2 groups were comparable for age, sex, and tumor grade. We assessed functional outcomes of the wrist with the Toronto Extremity Salvage Score, Musculoskeletal Tumor Society 1987 and 1993 scores, and Disabilities of the Arm, Shoulder, and Hand scores. RESULTS: Two local recurrences occurred in the VFFT group and 1 in the NICT group. The VFFT group had 3 patients who had already undergone or were planning to undergo surgery for improved appearance, hardware removal, or tendon release. In the NICT group, 2 infections required debridement, one of which went on to free fibular transfer, but there were no reoperations for nonunion or donor site morbidity. The surgical time was significantly shorter for NICT. Functional scores showed no differences between groups on any of the parameters studied for the upper limb. CONCLUSIONS: Both VFFT and NICT were effective surgical techniques for wrist fusion after distal radial resection for giant cell tumor. Vascularized free fibular transfer should be considered when a major skin defect is anticipated, because it allows the inclusion of a vascularized skin paddle, or when the osseous defect is too long (> 10 cm) for NICT. We were unable to demonstrate a difference in upper limb functional scores between VFFT and NICT. Because the surgical time is significantly shorter and the reoperation rate is lower for NICT, we recommend NICT whenever possible. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.

Patient Satisfaction with Pisiform Excision for Pisotriquetral Instability or Arthritis: A Prospective Review.

Background Pisotriquetral pain and instability is an elusive cause of ulnar-sided wrist pain. Initial treatment of chronic pisotriquetral pathology should involve a trial of nonoperative therapy such as neutral wrist splint, anti-inflammatories, and intra-articular steroid injections. The mainstay of surgical management of pisotriquetral pain is pisiform excision. Purpose This prospective study seeks to understand patient satisfaction after pisiform excision in patients with isolated pisotriquetral pathology. Patients and Methods A consecutive series of nine cases of pisiform excision was performed by the senior surgeon. The primary outcome measure was determined a priori to be the Patient-Rated Wrist Evaluation (PRWE) score. Wrist range of motion, grip strength, and QuickDASH (shortened version of Disabilities of the Arm, Shoulder and Hand) scores were also collected preoperatively and at 3 and 12 months postoperatively as secondary outcome measures. Results There was a very rapid improvement in the PRWE by 3 months, which was maintained at 12 months. The QuickDASH score was slower to improve, with a significant improvement by 12 months. There was no change in grip strength or wrist range of motion at any time point. Conclusion Pisiform excision results in a very rapid improvement of symptoms and should be considered in cases of pisotriquetral instability or arthritis that fail conservative management. Level of Evidence Level IV, case series.

Self-regulated and externally regulated learning in adolescence: Developmental trajectories and relations with teacher behavior, parent behavior, and academic achievement.

Both self-regulation and external regulation are key to understanding adolescents' learning and positive development at school. However, evidence on the joint development of self-regulated learning and externally regulated learning during adolescence is lacking. In addition, the current knowledge on interrelations between the development of adolescents' self-regulated learning, externally regulated learning, behaviors of teachers and parents in terms of autonomy support and achievement pressure, and academic achievement is very limited. The present multilevel longitudinal analysis focusing on the domain of mathematics (N = 1,542 German adolescents; annual assessments from Grades 5 to 9; mean age at Grade 5 = 11.79 years, SD = 0.71, 51.75% female) addressed these gaps. Results from multilevel latent basic growth curve models showed that self- and externally regulated learning decreased over the 5 years at both the individual student and the class level. Changes in self- and externally regulated learning were linked: Classes with higher levels of self-regulated learning at Grade 5 showed a stronger decrease in externally regulated learning over time. Initial levels of and changes in student-reported teacher and parental autonomy support and achievement pressure were associated with self- and externally regulated learning at the individual student level; student-reported teacher autonomy support and self-regulated learning were also linked at the class level. Self-regulated learning related positively to standardized achievement test scores but not to adolescents' grades. This study adds to the scarce evidence base on different regulatory forms of adolescents' learning and can inform future research on adolescents' positive development and educational practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Control, anxiety and test performance: Self-reported and physiological indicators of anxiety as mediators.

BACKGROUND: This study investigated the role of different test anxiety components (affective, cognitive, motivational and physiological) as mediators between control and performance as proposed by Pekrun's control-value theory (CVT). While all components were assessed via self-report, the physiological component was additionally assessed via electrodermal activity (EDA). AIMS: We examined the relative impact of the self-reported anxiety components and EDA in this mediating mechanism to identify the most relevant assessment(s) (i.e., self-reported anxiety components and/or EDA) for predicting test performance. SAMPLE: The study comprised 50 eighth graders. METHODS: Data were collected during a mathematics test comprising six task blocks. State self-reports of control and anxiety components along with test performance and other test emotions were collected block-wise (i.e., repeated assessments within students). EDA was continuously recorded. RESULTS: Consistent with CVT, intra-individual mediation analysis with multiple mediators revealed that higher control predicted lower anxiety (i.e., all self-reported components). Unexpectedly, higher control was associated with increased EDA. Follow-up analyses taking other test emotions into account suggested this might reflect positive activation. Correlations between EDA and control and self-reported anxiety components differed depending on which test emotion was dominant in each situation. Regarding test performance, only the cognitive component was a significant mediator and thus seems to play a pivotal role in the relationship between control and performance. CONCLUSIONS: Distinguishing between anxiety components and including unbiased physiological measures improve our understanding of the mechanisms behind the relationship between test anxiety and performance. Higher physiological arousal may be a sign of anxiety but can also be a sign of positive activation. When aiming to reduce negative effects of anxiety on performance, targeting the cognitive component seems crucial. Implications of these findings for educational and psychological practice are discussed.

Measuring emotions in mathematics: the Achievement Emotions Questionnaire-Mathematics (AEQ-M).

Understanding the structure, antecedents, and outcomes of students' emotions has become a topic of major interest in research on mathematics education. Much of this work is based on the Achievement Emotions Questionnaire-Mathematics (AEQ-M), a self-report instrument assessing students' mathematics-related emotions. The AEQ-M measures seven emotions (enjoyment, pride, anger, anxiety, shame, hopelessness, boredom) across class, learning, and test contexts (internal structure). Based on control-value theory, it is assumed that these emotions are evoked by control and value appraisals, and that they influence students' motivation, learning strategies, and performance (external relations). Despite the popularity and frequent use of the AEQ-M, the research leading to its development has never been published, creating uncertainty about the validity of the proposed internal structure and external relations. We close this gap in Study 1 (N = 781 students, Grades 5-10, mean age 14.1 years, 53.5% female) by demonstrating that emotions are organized across contexts and linked to their proposed antecedents and outcomes. Study 2 (N = 699 students, Grade 7 and 9, mean age 14.0 years, 56.9% female) addresses another deficit in research on the AEQ-M, the lack of evidence regarding the assumption that emotions represent sets of interrelated affective, cognitive, motivational, and physiological/expressive components. We close this gap by evaluating extended AEQ-M scales, systematically assessing these components for five core mathematics emotions (enjoyment, anger, anxiety, hopelessness, boredom). Our work provides solid grounds for future research using the AEQ-M to assess emotions and their components in the domain of mathematics.

Anteromedial coronoid fractures: technical description of an extensile surgical approach and outcomes from a small series using this technique.

Background: Varus posteromedial rotatory instability is a difficult clinical problem to diagnose and treat. Fixation of the anteromedial coronoid fracture is often necessary to achieve elbow stability. We describe an extensile surgical approach to the anteromedial coronoid. Methods: A retrospective review was performed of all patients at our institution who had anteromedial coronoid fracture fixed with this approach between 2012 and 2020. Results: Six patients were identified. They all achieved a stable elbow. Four of 6 developed heterotopic ossification and 2/6 required further surgery for this. Only 1 patient had a transient ulnar sensory loss. Conclusion: We describe an approach to the coronoid that allows great visualization of the joint and access to large coronoid fractures. The approach is extensile and does not require extensive dissection or work around the ulnar nerve. Access to fracture and for fixation can be improved by release of the common flexor pronator origin and the medial collateral ligament.