J Hand Surg Am.  |  eCollection 2019 Oct-Dec. Chin J Traumatol. eCollection 2020 Dec. J Clin Med. 0000048894 00000 n This objective remains a challenge for surgeons due to the complexity of the lesion.5 Repair of tendon, artery and skeletal injuries. 0000016448 00000 n of Orthopaedics and Sports Medicine University of Washington School of Medicine <]/Prev 879955>> NIH Relatively few studies have documented the outcomes of terrible triad injuries of the elbow. J Bone Joint Surg Am. 0000001940 00000 n 0000049289 00000 n 0000033983 00000 n 0000004662 00000 n 0000003713 00000 n Current elbow fracture dislocation classification systems only describe one element of the injury, or only include one pattern of elbow fracture dislocation. Elbow extension with forearm supination and added valgus stress puts most strain on the ulnohumeral joint, radial head and MCL respectively, causing a posterolateral rotational instability pattern of fracture-dislocation which includes posterior dislocation with a radial head fracture and the terrible triad injury with an added coronoid fracture. The terrible triad primarily occurs in adults; the flexibility of ligaments in children make this constellation unlikely 4.. 2020 Mar 19;54(Suppl 2):254-259. doi: 10.1007/s43465-020-00090-x. J Am Acad Orthop Surg. Pipicelli JG, Chinchalkar SJ, Grewal R, Athwal GS. 2014 Dec;37(12):831-7. doi: 10.3928/01477447-20141124-06. protocols. 1 Introduction. In general, terrible triad injuries are the result of a fall onto an outstretched hand. [Posteromedial dislocation of the elbow with lateral condyle and coronoid process fractures: a case report]. Wrist reconstruction including fusion. It is postulated that there is a posterolateral load upon the elbow during the fall, which results in tension failure of the LCL and the MCL, and a compressive load that fractures the radial head. 0000002959 00000 n 0000020945 00000 n 21. This injury almost always renders the elbow unstable requiring surgical intervention. Mathew PK, Athwal GS, King GJ. 0000006129 00000 n Buttress plate fixation of coronoid process fractures via a medial approach. Terrible triad injury of the elbow: current concepts. J Am Acad Orthop Surg. 0000001156 00000 n NLM 2009 Mar. An elbow dislocation associated with a displaced fracture of the radial head and coronoid process almost always renders the elbow unstable, making surgical fixation necessary. In some accidents, the elbow dislocates (the radius and ulna are pulled apart from the humerus) without any bones breaking; surgeons call this injury … A new comprehensive classification system based on the three-column concept of elbow fracture dislocation is presented with a suggested algorithm for managing each injury pattern. 20. Clipboard, Search History, and several other advanced features are temporarily unavailable. PubMed PMID: 20449590; PubMed Central PMCID: PMC3103950. Epub 2019 Aug 9. Mathew PK, Athwal GS, King GJ. Terrible triad injury of the elbow: current . A delay in treatment or revision surgery resulted in a 20% greater loss of … 2014;37(12):831-837. van Riet RP, Morrey BF. The terrible triad of the elbow is a severe elbow fracture-dislocation pattern and is so-called because it has poor medium-to-long term outcome.. 0000003156 00000 n 0000010486 00000 n Advances in knowledge combined with improved implants and surgical techniques have contributed to better outcomes. Terrible Triad Injury of the Elbow: Current Concepts. - Discussion: - terrible triad: (RHF + MCL + coronoid process frx) + elbow dislocation - in this injury there is little to keep the elbow reduced; - general operative considerations: 1) radial head: repair or replacement of the radial head (see ORIF or radial head) - concomitant excision of radial head and coronoid process is not performed since it may result in marked instability; ;8EDA��� ��`[1��E���"t�Bʕ� ,uh�F�ԕ �՚��e��I. Orthop Clin North Am 44: 47–58. Rehabilitation considerations in the management of terrible triad injury to the elbow. 2020 Jan;8(1):4-9. doi: 10.29252/beat-080102. The terrible triad injury of the elbow, dislocation of the ulnohumeral joint with fractures of the coronoid process and radial head, is difficult to treat and has a historically poor outcome. Pk, Athwal GS, King GJ C, Chouhan D. Bull Emerg Trauma historically have poor...., Singh K, meena S, Kumbhare C, Chouhan D. 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