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. 2015 Jul 3;50(4):403-8.
doi: 10.1016/j.rboe.2015.06.010. eCollection 2015 Jul-Aug.

Result from surgical treatment on the terrible triad of the elbow

Anderson de Aquino Santos  1 , Thomaz Antônio Tonelli  1 , Fabio Teruo Matsunaga  1 , Marcelo Hide Matsumoto  1 , Nicola Archetti Netto  1 , Marcel Jun Sugawara Tamaoki  1
Affiliations

Result from surgical treatment on the terrible triad of the elbow

Anderson de Aquino Santos et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Objective: To evaluate the results from surgical treatment of the terrible triad of the elbow, with a minimum of six months of follow-up, taking elbow function into consideration.

Methods: The analyzed aspects of 20 patients, who underwent surgical treatment of the terrible triad of the elbow, were given as follows: Dash score (Disabilities of the Arm, Shoulder and Hand), Meps (Mayo Elbow Performance Score), pain according to VAS (visual analog scale), ROM (range of motion), patient satisfaction, degree of energy of the trauma, complications and radiographs.

Results: The mean length of follow-up among the patients was 38 months. There were statistically significant relationships between the following set of parameters: trauma mechanism and patient satisfaction; radiological outcome of "heterotopic ossification" and satisfaction; functional flexion-extension ROM and satisfaction; and between type of radial head fracture and presence of a radiological outcome.

Conclusion: The surgical treatment for the terrible triad of the elbow generally provided satisfactory results, when the functioning of this joint upon the return to activities was taken into consideration.

Objetivo: Avaliar os resultados do tratamento cirúrgico da tríade terrível do cotovelo, com no mínimo seis meses de seguimento, considerando a função do cotovelo.

Métodos: Foram analisados os seguintes aspectos de 20 pacientes submetidos a tratamento cirúrgico por tríade terrível do cotovelo: escores Dash (Disabilities of the Arm, Shoulder and Hand), Meps (Mayo Elbow Performance Score), dor pela EVA (Escala Visual Analógica), ADM (arco de movimento), satisfação do paciente, grau de energia do trauma, complicações e radiografias.

Resultados: O tempo médio de seguimento dos pacientes foi de 38 meses. Houve relação estatisticamente significativa entre: mecanismo de trauma e satisfação dos pacientes; desfecho radiológico “ossificação heterotópica” e satisfação; ADM funcional de flexo-extensão e satisfação e entre o tipo de fratura da cabeça do rádio e a presença de desfecho radiológico.

Conclusão: O tratamento cirúrgico da tríade terrível do cotovelo proporcionou, de forma geral, resultados satisfatórios, quando se considera a função dessa articulação no retorno às atividades.

Keywords: Dislocation; Elbow; Fracture; Orthopedic surgery.

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Figures

Fig. 1
Fig. 1
Front and lateral-view radiographs of the elbow demonstrating the results from the surgical treatment, with lateral ligament repair using an anchor, radial head prosthesis and osteosynthesis of the coronoid using a screw.
See this image and copyright information in PMC

References

    1. Hotchkiss R.N. Fractures and dislocations of the elbow. In: Rockwood C.A., Green D.P., Bucholz R.W., Heckman J.D., editors. Rockwood and Green's fractures in adults. 4th ed. Lippincott-Raven; Philadelphia: 1996. pp. 929–1024.
    1. Rodriguez-Martin J., Pretell-Mazzini J., Andres-Esteban E.M., Larrainzar-Garijo R. Outcomes after terrible triads of the elbow treated with the current surgical protocols: a review. Int Orthop. 2011;35(6):851–860. - PMC - PubMed
    1. Chan K., MacDermid J.C., Faber K.J., King G.J., Athwal G.S. Can we treat select terrible triad injuries nonoperatively? Clin Orthop Relat Res. 2014;472(7):2092–2099. - PMC - PubMed
    1. Guitton T.G., Ring D. Nonsurgically treated terrible triad injuries of the elbow: report of four cases. J Hand Surg Am. 2010;35(3):464–467. - PubMed
    1. Mathew P.K., Athwal G.S., King G.J. Terrible triad injury of the elbow: current concepts. J Am Acad Orthop Surg. 2009;17(3):137–151. - PubMed

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