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International Orthopaedics
Published in: International Orthopaedics 6/2011

01-06-2011 | Review

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

Authors: Juan Rodriguez-Martin, Juan Pretell-Mazzini, Eva Maria Andres-Esteban, Ricardo Larrainzar-Garijo

Published in: International Orthopaedics | Issue 6/2011

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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.
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Metadata
Title
Outcomes after terrible triads of the elbow treated with the current surgical protocols. A review
Authors
Juan Rodriguez-Martin
Juan Pretell-Mazzini
Eva Maria Andres-Esteban
Ricardo Larrainzar-Garijo
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 6/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-010-1024-6

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