Outcomes after terrible triads of the elbow treated with the current surgical protocols. A review

Juan Rodriguez-Martin, Juan Abelardo Augusto Pretell, Eva Maria Andres-Esteban, Ricardo Larrainzar-Garijo

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Dislocation of the elbow associated with radial head and coronoid fracture, the so-called "terrible triad" of the elbow, is challenging to treat and has a history of complicated outcomes. However, advances in the knowledge of elbow kinematics combined with improved implants and surgical techniques during the past few years have led to the development of standard surgical protocols. This review article analyses the results in 137 elbow triad injuries of five studies treated using the current protocols. These include fixation of the coronoid fracture, repair or replacement the radial head, and repair of the lateral ligament complex, reserving medial collateral ligament repair and application of hinged external fixation for patients with residual instability. Treatment of these demanding injuries appeared effective in the majority of cases, i.e. with an average of 31 months of follow-up, overall flexion arc was 111.4°, averaged flexion was 132.5° with forearm rotation of 135.5°, Mayo elbow performance score was 85.6 points, and Broberg-Morrey score was 85 points. Nevertheless, the patient should be informed about the incidence of complications including joint stiffness, ulnar nerve symptoms or post-traumatic arthritis.

Original languageEnglish (US)
Pages (from-to)851-860
Number of pages10
JournalInternational Orthopaedics
Volume35
Issue number6
DOIs
StatePublished - Jun 2011
Externally publishedYes

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Elbow
Collateral Ligaments
Fracture Fixation
Ulnar Nerve
Wounds and Injuries
Biomechanical Phenomena
Forearm
Arthritis
Joints
Incidence
Therapeutics

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Outcomes after terrible triads of the elbow treated with the current surgical protocols. A review. / Rodriguez-Martin, Juan; Pretell, Juan Abelardo Augusto; Andres-Esteban, Eva Maria; Larrainzar-Garijo, Ricardo.

In: International Orthopaedics, Vol. 35, No. 6, 06.2011, p. 851-860.

Research output: Contribution to journalArticle

Rodriguez-Martin, Juan ; Pretell, Juan Abelardo Augusto ; Andres-Esteban, Eva Maria ; Larrainzar-Garijo, Ricardo. / Outcomes after terrible triads of the elbow treated with the current surgical protocols. A review. In: International Orthopaedics. 2011 ; Vol. 35, No. 6. pp. 851-860.
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