terrible triad injury of the elbow: current concepts

The terrible triad primarily occurs in adults; the flexibility of ligaments in children make this constellation unlikely 4.. PubMed PMID: 20449590; PubMed Central PMCID: PMC3103950. 0000000016 00000 n J Bone Joint Surg Am. 0000003012 00000 n HHS The primary goal of surgery is to stabilize the elbow to permit early motion to prevent stiffness. 2009 Mar. 0  |  0000002217 00000 n 0000016448 00000 n 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. Clin Orthop Relat Res. Mid-Term Postoperative Outcomes Following a Standardized Protocol. Bohn K, Ipaktchi K, Livermore M, Cao J, Banegas R. Current treatment concepts for “terrible triad” injuries of the elbow. 0000006129 00000 n 0000020945 00000 n Fracture-dislocations of the elbow remain among the most difficult injuries to manage. xref %%EOF NIH 0000002922 00000 n concepts. Terrible triad injury of the elbow: current concepts Fracture-dislocations of the elbow remain among the most difficult injuries to manage. doi: 10.2106/JBJS.OA.19.00017. eCollection 2019 Oct-Dec. Chin J Traumatol. Please enable it to take advantage of the complete set of features! Documentation of associated injuries occurring with radial head fracture. Terrible triad injury of the elbow: current . 0000003713 00000 n 0000001940 00000 n 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. Outcomes after terrible triads of the elbow treated with the current surgical . 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. Rehabilitation considerations in the management of terrible triad injury to the elbow. Injury. Epub 2019 Aug 9. Clipboard, Search History, and several other advanced features are temporarily unavailable. Hotchkiss introduced this concept 1996 5; Zhang et … 0000006693 00000 n 2020 Mar 19;54(Suppl 2):254-259. doi: 10.1007/s43465-020-00090-x. 0000048894 00000 n 2014 Feb;33(1):63-6. doi: 10.1016/j.main.2013.11.005. of Orthopaedics and Sports Medicine University of Washington School of Medicine Clin Orthop Relat Res. Mathew PK, Athwal GS, King GJ. 19. Terrible triad injuries of the elbow: does the coronoid always need to be fixed? 0000028049 00000 n Papatheodorou LK, Rubright JH, Heim KA, Weiser RW, Sotereanos DG. 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. COVID-19 is an emerging, rapidly evolving situation. 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.. 2009 Mar;17(3):137- 51. Review. Terrible triad injury of the elbow: current concepts. The primary goal of surgical fixation is to stabilize the elbow to permit early motion. eCollection 2020 Dec. J Clin Med. 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. Int Orthop. Terrible triad injury of the elbow: current . Broberg MA, Morrey BF. Hongwei Chen*and Guolin Wu Department of Orthopedics, Yiwu Central Hospital, Yiwu, Zhejiang Province, PR China *Corresponding Author: 1. USA.gov. Chemama B, Bonnevialle N, Peter O, Mansat P, Bonnevialle P. Orthop Traumatol Surg Res. 0000001750 00000 n Meena MK, Singh K, Meena S, Kumbhare C, Chouhan D. Bull Emerg Trauma. 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. In some accidents, the elbow dislocates (the radius and ulna are pulled apart from the humerus) without any bones breaking; surgeons call this injury … Sep 19, 2016 - Treatment of dislocated elbow. This site needs JavaScript to work properly. 2010 Apr;96(2):147-54. doi: 10.1016/j.rcot.2010.02.008. Lateral Approach Versus Combined Lateral and Anteromedial Approach for Surgical Treatment of Terrible Triad of Elbow: A Meta-Analysis. J Am Acad Orthop Surg. Total elbow arthroplasty. 0000003802 00000 n Current treatment concepts for "terrible triad" injuries of the elbow. 1 Introduction. Arthritis reconstruction of the thumb and fingers. 0000001668 00000 n 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. Repair of tendon, artery and skeletal injuries. <]/Prev 879955>> [Posteromedial dislocation of the elbow with lateral condyle and coronoid process fractures: a case report]. 0000003233 00000 n 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. Orthop Clin North Am 44: 47–58. 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. 0000010818 00000 n 0000010486 00000 n Current treatment concepts for "terrible triad" injuries of the elbow. 0000049289 00000 n h�b```e``������8�A��2l,=n@IG�������� �3d�����}B�z��������fzm��T3��(�UY�����N���"��L&Mth���]���M汧VB�xa L��⒗��م�! Mathew PK, Athwal GS, King GJ. The origins of the medial collateral ligament (MCL) and lateral collateral ligament (LCL) complexes avulse from the epicondyles and the 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.  |  Pathology The injury is characterized by elbow instability and development of arthrosis and joint stiffness. J Hand Surg Am. 0000007501 00000 n 2011 Jun;35(6):851-60. Key words Terrible, triad, elbow, fracture, instability. Dodds SD, Fishler T (2013) Terrible triad of the elbow. %PDF-1.4 %���� trailer 2014;37(12):831-837. van Riet RP, Morrey BF. 2020 Oct 29;9(11):3500. doi: 10.3390/jcm9113500. An elbow dislocation associated with a radial head and coronoid fractures is termed a terrible triad. Wrist reconstruction including fusion. - Epub 2008 Aug 0000031488 00000 n In general, terrible triad injuries are the result of a fall onto an outstretched hand. Terrible triad injuries are difficult to manage and historically have poor outcomes. If left untreated, they commonly result in functional compromise and poor outcomes. 0000049006 00000 n If left untreated, they commonly result in functional compromise and poor outcomes. 20. 1979;61(1):63-8. Elbow fracture-dislocations destabilize the elbow, preventing functional rehabilitation. 142 0 obj <>stream PubMed PMID: 19264707. Pipicelli JG, Chinchalkar SJ, Grewal R, Athwal GS. Historically, the combination of an elbow dislocation, a radial head fracture, and a coronoid process fracture has had a consistently … Radiographic Predictors of Medial Collateral Ligament Injury and Stability of the Elbow. 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. J Am Acad Orthop Surg. 0000008532 00000 n View Article When nonsurgical treatment is to be undertaken, several specific criteria must be met. 0000015536 00000 n A review. 0000003077 00000 n 0000005408 00000 n 2008 Dec;39(12):132937. 0000001156 00000 n A new comprehensive classification system based on the three-column concept of elbow fracture dislocation is presented with a suggested algorithm for managing each injury pattern. Terrible Triad Injury of the Elbow: Current Concepts. 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. Some circumstantial evidence supports this concept. 0000033983 00000 n ;8EDA��� ��`[1��E���"t�Bʕ� ,uh�F�ԕ �՚��e��I. Terrible triad injury of the elbow is a complex injury that is classically defined as elbow dislocation along with fractures of the coronoid process of the ulna and the radial head. Mathew PK, Athwal GS, King GJ (2009) Terrible triad injury of the elbow: current concepts. 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. 0000004662 00000 n Epub 2013 Dec 12. NLM 2014 Dec;37(12):831-7. doi: 10.3928/01477447-20141124-06. Fracture dislocation of the elbow, termed terrible triad, involves three anatomic injuries: coronoid fracture, radial head fracture, and posterior elbow dislocation. 21. See more ideas about dislocation, elbow, treatment. The terrible triad of the elbow is characterized by great potential for joint instability and an unfavorable prognosis.1, 5Surgical treatment is the therapy of choice in the vast majority of cases, with the aims of restoration of the anatomy and early mobility. 3), and is often associated with collateral ligaments injuries. Elbow extension with forearm supination and added valgus stress puts most strain on the ulnohumeral joint, radial head and MCL respectively, causing a posterolateral rotational instability pattern of fracture-dislocation which includes posterior dislocation with a radial head fracture and the terrible triad injury with an added coronoid fracture. 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