terrible triad injury of the elbow: current concepts

Wrist reconstruction including fusion. 2009 Mar. Advances in knowledge combined with improved implants and surgical techniques have contributed to better outcomes. 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.. T HE TERRIBLE TRIAD OF THE ELBOW is posterior or posterolateral dislocation of the ulnohumeral joint with fractures of the radial head and coronoid process. The origins of the medial collateral ligament (MCL) and lateral collateral ligament (LCL) complexes avulse from the epicondyles and the Reconstruction of pediatric hand defects and injuries. J Hand Surg Am. If left untreated, they commonly result in functional compromise and poor outcomes. Bohn K, Ipaktchi K, Livermore M, Cao J, Banegas R. Orthopedics. J Am Acad Orthop Surg. h�b```e``������8�A��2l,=n@IG�������� �3d�����}B�z��������fzm��T3��(�UY�����N���"��L&Mth���]���M汧VB�xa L��⒗��م�! View Article Google Scholar 3. Fracture-dislocations of the elbow remain among the most difficult injuries to manage. 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.  |  USA.gov. Relatively few studies have documented the outcomes of terrible triad injuries of the elbow. xref We analyzed prospectively a series of patient affected by TTI and treated according to the current diagnostic and surgical protocols to investigate whether their application allow to obtain more predictable outcomes. 0000002922 00000 n 0000012131 00000 n Terrible triad injuries of the elbow: does the coronoid always need to be fixed? 3), and is often associated with collateral ligaments injuries. of Orthopaedics and Sports Medicine University of Washington School of Medicine National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. If left untreated, they commonly result in functional compromise and poor outcomes. Mathew PK, Athwal GS, King GJ (2009) Terrible triad injury of the elbow: current concepts. 0000004662 00000 n 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. - Epub 2008 Aug Broberg MA, Morrey BF. Terrible triad injury of the elbow: current concepts. concepts. 0000028049 00000 n Terrible Triad Injury of the Elbow: Current Concepts. Terrible triad injury of the elbow: current concepts Fracture-dislocations of the elbow remain among the most difficult injuries to manage. 2007 Oct. 32 (8):1200-9. Pipicelli JG, Chinchalkar SJ, Grewal R, Athwal GS. J Am Acad Orthop Surg 17: 137–151. 21. 0000006693 00000 n Recent literature has improved our understanding of elbow anatomy and biomechanics along with the pathoanatomy of this injury, thereby allowing the development of a systematic approach for treatment and rehabilitation. 20. Mid-Term Postoperative Outcomes Following a Standardized Protocol. Terrible triad injury of the elbow: current . Bohn K, Ipaktchi K, Livermore M, Cao J, Banegas R. Current treatment concepts for “terrible triad” injuries of the elbow. A terrible triad injury of the elbow consists of an ulnohumeral dislocation with associated fractures of the coronoid and radial head. Current treatment concepts for "terrible triad" injuries of the elbow. Radial Head Fixation vs Replacement in Terrible Triad: Preliminary Results of a Prospective Cohort Study with Patient Reported Outcome. In some accidents, the elbow dislocates (the radius and ulna are pulled apart from the humerus) without any bones breaking; surgeons call this injury … 0000001940 00000 n Mathew PK, Athwal GS, King GJ. Historically, the combination of an elbow dislocation, a radial head fracture, and a coronoid process fracture has had a consistently poor outcome; for this reason, it is called the terrible triad. 2: Mathew PK, Athwal GS, King GJ. PubMed PMID: 19264707. This objective remains a challenge for surgeons due to the complexity of the lesion.5 This injury almost always renders the elbow unstable requiring surgical intervention.  |  0000016448 00000 n Outcomes after terrible triads of the elbow treated with the current surgical . %%EOF 2011 Jun;35(6):851-60. Fracture dislocation of the elbow, termed terrible triad, involves three anatomic injuries: coronoid fracture, radial head fracture, and posterior elbow dislocation. Radiographic Predictors of Medial Collateral Ligament Injury and Stability of the Elbow. This site needs JavaScript to work properly. The terrible triad of the elbow is defined as the combination of fractures of the radial head and ulnar coronoid process and dislocation of the elbow joint 4 (Fig. 2010 Apr;96(2):147-54. doi: 10.1016/j.rcot.2010.02.008. Buttress plate fixation of coronoid process fractures via a medial approach. 0000009316 00000 n Morrey BF, Chao EY, Hui FC. 2020 Mar 19;54(Suppl 2):254-259. doi: 10.1007/s43465-020-00090-x. 2009 Mar;17(3):137- 51. Review. 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. An elbow dislocation associated with a radial head and coronoid fractures is termed a terrible triad. <]/Prev 879955>> Papatheodorou LK, Rubright JH, Heim KA, Weiser RW, Sotereanos DG. The injury is characterized by elbow instability and development of arthrosis and joint stiffness. 0000003156 00000 n Hotchkiss introduced this concept 1996 5; Zhang et … 0000033780 00000 n Rehabilitation considerations in the management of terrible triad injury to the elbow. 0000049289 00000 n The "terrible triad" injury is classically described as a combination of a coronoid process and radial head fractures, as well as a … Epidemiology. [Posteromedial dislocation of the elbow with lateral condyle and coronoid process fractures: a case report]. eCollection 2019 Oct-Dec. Chin J Traumatol. 0000003713 00000 n startxref 0000007501 00000 n protocols. Injury. COVID-19 is an emerging, rapidly evolving situation. Please enable it to take advantage of the complete set of features! 0000049079 00000 n 1979;61(1):63-8. 100 43 Historically, the combination of an elbow dislocation, a radial head fracture, and a coronoid process fracture has had a consistently … Chemama B, Bonnevialle N, Peter O, Mansat P, Bonnevialle P. Orthop Traumatol Surg Res. concepts. Elbow fracture-dislocations destabilize the elbow, preventing functional rehabilitation. 0000003077 00000 n Orthop Clin North Am 44: 47–58. %PDF-1.4 %���� 19. Terrible Triad Injury of the Elbow: Current Concepts 140Journal of the American Academy of Orthopaedic Surgeons structures of the elbow begin to fail from lateral to medial.24The anterior bundle of the MCL is postulated to be the last to fail; therefore, an el- bow can theoretically dislocate with- out a complete tear of this structure. Orthopaedic & Sports Medicine Grand Rounds - February 3, 2016 - Terrible Triad Injuries and the Complex Elbow: Current Concepts Presented by: Daphne M. Beingessner, MSc, MD, FRCSC Associate Professor of Traumatology Harborview Medical Center Dept. HHS 0000010486 00000 n Does the Coronoid Always Need to Be Fixed in Terrible Triad Injuries of the Elbow? Terrible triad injury of the elbow: current concepts. 0000003233 00000 n A review. Clin Orthop Relat Res. 2014;37(12):831-837. van Riet RP, Morrey BF. 100 0 obj <> endobj A terrible triad combines three injuries: dislocation of the elbow, fracture of the radial head, and fracture of the coronoid. J Am Acad Orthop Surg. Hongwei Chen*and Guolin Wu Department of Orthopedics, Yiwu Central Hospital, Yiwu, Zhejiang Province, PR China *Corresponding Author: 1. Orthopedics. 2014 Jul;472(7):2084-91. doi: 10.1007/s11999-014-3471-7. The “terrible triad” injury is classically described as a combination of a coronoid process and radial head fractures, as well as a posterolateral elbow dislocation. 0000002959 00000 n 0000049006 00000 n The primary goal of surgical fixation is to stabilize the elbow to permit early motion. The primary goal of surgery is to stabilize the elbow to permit early motion to prevent stiffness. The terrible triad primarily occurs in adults; the flexibility of ligaments in children make this constellation unlikely 4.. 0000006129 00000 n Dodds SD, Fishler T (2013) Terrible triad of the elbow. Terrible triad injury of the elbow: current . Key words Terrible, triad, elbow, fracture, instability. The unhappy triad, also known as a blown knee among other names, is an injury to the anterior cruciate ligament, medial collateral ligament, and meniscus.Analysis during the 1990s indicated that this 'classic' O'Donoghue triad is actually an unusual clinical entity among athletes with knee injuries. 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Surg Res ):255-260. doi: 10.29252/beat-080102, several specific criteria must be met ):831-837. Riet. Weiser RW, Sotereanos DG Ipaktchi K, Ipaktchi K, Ipaktchi K, Ipaktchi K, Ipaktchi K Livermore... ; 15 ( 4 ): e0017 head fixation vs replacement in terrible triad of fracture! Rotation of 135° almost always renders the elbow unstable requiring surgical intervention ; 8 ( 1 ):4-9. doi 10.29252/beat-080102. Associated elbow dislocation with intra-articular fracture: the results of a Prospective Cohort study with reported. Dec ; 15 ( 4 ):198-208. doi: 10.3390/jcm9113500 and surgical techniques have contributed to outcomes. Coronoid process fractures: a Meta-Analysis of Medicine current treatment concepts for `` terrible triad of the elbow lateral... 2 ):147-54. doi: 10.1016/j.cjtee.2019.05.005 pathology terrible triad of the elbow excision...:63-6. doi: 10.1097/BTH.0b013e31822911fd 9 ( 11 ):3500. doi: 10.1097/BTH.0b013e31822911fd doi. 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