Coronoid fractures : how do we best classify them and what is the 'true terrible triad'?

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: L. E. Adolfsson reports royalties from Königsee AS and teaching payments from Acumed, Stryker, KLS Martin, Swemac Education, all of which are unrelated to this article. A. D. Duckworth reports research grants from the NIHR, OTA, and SORT-IT, book royalties from Taylor & Francis and Elsevier, and teaching payments from Medartis, Swemac, and Smith & Nephew, all of which are unrelated to this article. A. D. Duckworth also participates on various committees for multiple trials, and holds editorial and board member roles across a range of journals, including The Bone & Joint Journal. 15. J Hand Surg Am. 2015 Nov;40(11):2297-303. doi: 10.1016/j.jhsa.2015.04.039. Epub 2015 Oct 1. Terrible Triad Injuries of the Elbow. Chen NC(1), Ring D(2). Author information: (1)Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA. (2)Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA. Electronic address: dring@mgh.harvard.edu. The treatment of terrible triad injuries of the elbow continues to evolve. Radial head fixation and arthroplasty, coronoid process fixation, and repair of the lateral collateral ligament continue to be the mainstays of treatment. In the elbow with persistent instability after repair of these elements, application of a static external fixation, hinged external fixation, ulnohumeral joint pinning, or an internal hinge may be needed. In patients who undergo treatment after the acute injury period, the coronoid may require reconstruction using radial head autograft, iliac crest autograft, olecranon autograft, or allograft. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jhsa.2015.04.039