The terrible triad of the elbow consists of radial head fracture and coronoid process fracture in addition to posterior dislocation of the elbow. It indicates high-risk complications such as instability, malunion, nonunion, and proximal radioulnar synostosis. We describe a rare case that was admitted to the emergency service with a terrible triad of the elbow with additional capitellum fracture, lateral collateral ligament (LCL) injury, and ipsilateral humeral shaft fracture. We treated the patient urgently by performing osteosynthesis of the humeral shaft fracture, radial head fracture, coronoid fracture, capitellum fractures, and repair of the LCL rupture. The terrible triad of the elbow also can be accompanied by adjacent column fractures, including the humeral shaft. In such complex cases, preoperative planning should be done well, and the entire anatomy should be demonstrated with additional imaging. Optimal treatment of all the fractured bones and ligaments is critical for early rehabilitation. The main aim of surgery is to acquire desired results by starting an early rehabilitation, including joint movement.
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http://dx.doi.org/10.7759/cureus.27658 | DOI Listing |
Orthop J Sports Med
January 2025
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Background: The aim of surgical treatment for posterolateral rotatory instability (PLRI) of the elbow is to restore the integrity of the lateral ulnar collateral ligament (LUCL), with ligamentous reconstruction being the preferred option for recurrent symptomatic PLRI. However, there is no clinical evidence demonstrating the superiority of reconstruction versus repair. Treatment options currently depend on the cause of the LUCL injury and surgeon preference.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Department of Hand & Reconstructive Microsurgery Surgery, Rashid Hospital, Dubai, United Arab Emirates.
Background: Open and crushed forearm injury is a complex and rare injury affecting the upper extremity. It results in damage to various structures, including bones, soft tissues, and neurovascular bundles, ultimately leading to functional impairment. Typically, these injuries occur owing to high-energy trauma.
View Article and Find Full Text PDFOrthop J Sports Med
December 2024
Twin Cities Orthopedics, Edina, Minnesota, USA.
Background: A new "terrible triad" has been reported to be an anterior cruciate ligament (ACL) tear with a concomitant medial meniscus ramp tear and lateral meniscus root tear. Patient-reported outcomes (PROs) for isolated ACL reconstruction (ACLR) versus an ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs are not well known.
Purpose: To compare postoperative outcomes between isolated ACLR and ACLR with concomitant medial meniscus ramp and lateral meniscus root repairs.
Malays Orthop J
November 2024
Department of Orthopaedics and Traumatology, Udayana University, Denpasar, Indonesia.
In young patients, the use of total elbow arthroplasty (TEA) is rarely preferred due to its high rate of mechanical failure. Poor compliance and psychological problems encountered may lead to increased difficulty in management. A 38-year-old male complained stiffness and pain on his left elbow.
View Article and Find Full Text PDFClin Orthop Relat Res
December 2024
Department of Orthopaedic Surgery, University Medical Centre Groningen and Groningen University, Groningen, the Netherlands.
Background: The terrible triad injury involves an ulnohumeral dislocation, radial head fracture, and coronoid process fracture. According to traditional teaching, these injuries are strongly associated with anterolateral coronoid tip fractures and can be addressed via a lateral approach to the elbow. However, recent small clinical series suggest that some terrible triad injuries have larger coronoid fractures involving the anteromedial facet.
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