Surgical treatment of terrible triad of the elbow.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 2. J Am Acad Orthop Surg. 2024 Oct 1;32(19):e982-e995. doi: 10.5435/JAAOS-D-24-00310. Epub 2024 Aug 13. Management of Elbow Terrible Triad Injuries: A Comprehensive Review and Update. Fahs A(1), Waldron J, Afsari A, Best B. Author information: (1)From the Ascension St. John Medical Center, Detroit, MI (Fahs, Waldron, Afsari, and Best), Ascension Macomb-Oakland Hospital, Warren, MI (Fahs, Waldron, Afsari, and Best). The "terrible triad" of the elbow, encompassing elbow dislocation, radial head fracture, and coronoid process fracture, remains a formidable challenge in orthopaedic practice. Typically, stabilizing structures in the elbow fail from lateral to medial through a posterolateral rotatory force after a fall onto an outstretched upper extremity. Surgery is often needed to repair the lateral ligamentous complex, replace or fix the radial head, possibly repair the anterior capsule or fix the coronoid, and consider medial repair or application of an internal versus external fixator. However, in some challenging cases persistent instability, complications, and loss of function may occur. Rehabilitation focuses on achieving early range of motion to prevent stiffness which can be common after these injuries. By integrating emerging approaches with established practices, this article aims to guide orthopaedic surgeons toward a fundamental understanding of terrible triad injuries and assist with informed management principles of these complex injuries. Copyright © 2024 by the American Academy of Orthopaedic Surgeons. DOI: 10.5435/JAAOS-D-24-00310