Revista de la Asociación Argentina de Ortopedia y Traumatología
versión On-line ISSN 1852-7434
GALLUCCI, Gerardo L et al. Treatment protocol for the terrible triad of the elbow. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2011, vol.76, n.3, pp. 232-241. ISSN 1852-7434.
Background: Elbow dislocations associated with radial head and coronoid fractures have been termed the "terrible triad of the elbow" because of the difficulties in treatment and the poor reported outcomes. The purpose of this paper is to report the results of a consecutive series of patients with terrible triad and describe our protocol of treatment. Methods: We included 15 patients in which coronoid fracture, radial head fracture and lateral ligament had been repaired. Twelve were women and 3 men. Average age was 57 years old. The protocol of treatment was: 1) to restore the stability of coronoid fracture, 2) of the radial head, 3) to repair the lateral ligament, 4) to repair the medial collateral ligament if the stability was not obtained and 5) immobilization for 2 weeks. Pain was evaluated according to VAS and functional results with the DASH and Mayo Clinic Score. Follow-up was 34 months. Results: The flexo-extension was 139°-11º (total arc 128°). Pain was 2, DASH score was 12. Seven were excellent and 8 good. Complications: a radial head nonunion, a cubital neurodocitis, a stiff elbow and a valgus instability. Conclusions: The application of a correct protocol of treatment can favour the results. Some complications are expected.
Palabras clave : Luxation; Radial head; Coronoid; Terrible triad..