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terrible triad elbow treatment

A terrible triad injury of the elbow is a term used to describe a dislocation of the elbow with a fracture at the top of the radial bone (forearm) and the coronoid, the part of the elbow that holds the head of the humerus, the upper arm bone.Because of the extent of the injury, the usual treatment is open surgery. Article Details 1. Lateral options: 1.2.1.1. Diagnosis. 11 An understanding of the specific anatomy of these structures is paramount to the successful treatment of terrible triad injuries. Click here to Login. To report the results of the surgical treatment of terrible triad injury with anteromedial coronoid fracture through a combined surgical approach. Login. (eds) Rockwood and Green’s fractures in adults. Radial head replacement might be a more effective treatment approach with good clinical outcomes for patients with a terrible triad of the elbow. Methods: Eight patients identified with “terrible triad” injury patterns, including posterior elbow dislocation, radial head fracture and coronoid fracture, were available for a minimum of 11 months follow-up. The four injuries that will be discussed include Monteggia fracture-dislocation, distal humerus fracture, terrible triad, and transolecranon fracture. 2017 Apr;29(2):125-137. doi: 10.1007/s00064-017-0489-5. Therefore, the preferred surgical treatment options in the setting of terrible triad injuries include open reduction and internal fixation (ORIF) or radial head arthroplasty . The elbow is the second most commonly dislocated joint in adults and up to 20% of dislocations are associated with a fracture. The 'terrible triad of the elbow' refers to a combination of elbow dislocation and radial head and coronoid process fracture - it is notoriously difficult to manage although a systematic review found that whilst complications are common, functional outcomes are generally satisfactory . Joaquin Sanchez-Sotelo. Schematic illustration showing a fracture of the anteromedial facet of the coronoid extending to involve the tip of the coronoid process (fracture fragment indicated by dotted lines). If the elbow is unstable after repair of the coronoid, radiohumeral joint and LCL then the MCL can be repaired. The purpose of treatment in the terrible triad injury is to restore the congruency of the elbow joint, its stability and an optimal ROM. ORIF of Distal Humerus Fractures 07:51. With operative treatment, the surgeon should attempt to perform internal fixation of the coronoid fracture, to regain normal radiocapitellar contact (either by preserving the radial head with open reduction and internal Conclusions: Our review had indicated that patients with terrible triad injuries undergo arthroplasty replacement have better clinical outcomes and fewer post-surgery complications than those received the repair surgery. Patient prone with elbow flexed at 90 degrees at edge of bed. Most repairs can be done from the lateral side. Objective To report the results of the surgical treatment of terrible triad injury with anteromedial coronoid fracture through a combined surgical approach. Generally these should commence around day 7-10 for a terrible triad or elbow dislocation unless otherwise specified in the operating report. Following a fall-on-outstretched-hand injury, this patient presented with elbow dislocation in addition to fractures of both the radial head and coronoid process, consistent with a terrible triad of the elbow injury. See this image and copyright information in PMC. Radial head replacement might be a more effective treatment approach with good clinical outcomes for patients with a terrible triad of the elbow. 4 and 5). USA.gov. Injury 2014; 45: 942–948. Lateral options: 1.2.1.1. Available online 14 December 2020, 102784, Surgical treatment of terrible triad of the elbow. should instability persist after addressing the radial head and the LCL complex in the presence of a small coronoid fracture, the next best step is MCL reconstruction. 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. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. Algorithm for surgical treatment of terrible triad elbow injuries. Treatment strategy of terrible triad of the elbow: experience in Shanghai 6th People's Hospital. Surgical technique. J Bone Joint Surg Am 2004; 86: 1122–1130. Please enable it to take advantage of the complete set of features! 20:08. Surgical treatment for terrible triad injury of the elbow with anteromedial coronoid fracture through a combined surgical approach Our review had indicated that patients with terrible triad injuries undergo arthroplasty replacement have better clinical outcomes and fewer post-surgery complications than those received the repair surgery. Clipboard, Search History, and several other advanced features are temporarily unavailable. For this reason, it has been called the “terrible triad injury” of the elbow [3] Terrible triad injuries can lead to pain, recurrent instability, sti ness, and posttraumatic Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. By Joaquin Sanchez-Sotelo 58 Videos. In the past, most of these injuries were treated by manipulative reduction and cast immobilization. Terrible triad injuries of the elbow: does the coronoid always need to be fixed? Score ( MEPS ) and anteroposterior ( D ) radiographs show an joint! Radiographs of the elbow is the treatment of the elbow elbow in Rockwood CA, editor ; Jr Green! Injuries annually ( 1 ) fixation through combined approaches 2014 Jul ; 8 3. Goal of treatment are controversial: systematic medial collateral ligaments ± 26.3° and arc of was! Injuries that will be required if a large, repairable radial head replacement be. 2014 ): S68–S76, Mei K, Zhang j, Yun CJ, Qian C, JY! 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