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Results of terrible triads in the elbow: the advantage of primary restoration of medial structure

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The purpose of this study was to report the clinical and radiological outcomes and surgical strategy for terrible triad injury of the elbow. We hypothesized that the outcomes of this type of injury would be satisfactory if the medial structure was routinely restored at the same time as the repair of the lateral structure.

Methods

We retrospectively reviewed the results of this treatment performed in 13 elbows with terrible triads. Our surgical protocol included fixation or replacement of the radial head and repair of the ruptured lateral ulnar collateral ligament through the lateral traumatic window. In all cases, simultaneous fixation of the coronoid and repair of the common flexor muscle were performed through the medial traumatic window. In eight patients with medial collateral ligament injury, the ligament was always repaired. The follow-up period ranged from 18 to 41 months (mean, 25 months).

Results

The flexion-extension arc of the elbow averaged 128° and forearm rotation averaged 134.6°. The mean Mayo elbow performance score was 95 points (range, 85 to 100), which corresponded to ten excellent results, and three good results. Concentric stability was restored to all cases. As postoperative complications, one patient had ulnar nerve neuropathy.

Conclusions

The present operative procedures restoring all damaged lateral and medial structures through the lateral and the medial windows provided satisfactory clinical and radiological outcomes and are recommended for patients with terrible triad injury.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Korea University College of Medicine, Seoul, 136-705, Korea

    Woong-Kyo Jeong, Jong-Keon Oh & Won-Seok Lee

  2. Department of Orthopaedic Surgery, Konkuk Medical School, 4-12, Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea

    Jin-Ho Hwang & Seok-Min Hwang

Authors
  1. Woong-Kyo Jeong
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  2. Jong-Keon Oh
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  3. Jin-Ho Hwang
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  4. Seok-Min Hwang
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  5. Won-Seok Lee
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Jeong, WK., Oh, JK., Hwang, JH. et al. Results of terrible triads in the elbow: the advantage of primary restoration of medial structure. J Orthop Sci 15, 612–619 (2010). https://doi.org/10.1007/s00776-010-1515-8

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  • DOI: https://doi.org/10.1007/s00776-010-1515-8

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