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. 2016 Nov 14:22:4354-4362.
doi: 10.12659/msm.897297.

Surgical Outcomes and Complications in Treatment of Terrible Triad of the Elbow: Comparisons of 3 Surgical Approaches

Hong-Wei Chen  1 , Qing Bi  2
Affiliations

Surgical Outcomes and Complications in Treatment of Terrible Triad of the Elbow: Comparisons of 3 Surgical Approaches

Hong-Wei Chen et al. Med Sci Monit. .

Abstract

BACKGROUND This study compared the efficacy of combined lateral and medial approach, lateral approach, and anterior medial approach in treatment of terrible triad of the elbow (TTE). MATERIAL AND METHODS Thirty-eight TTE patients hospitalized in our center were retrospectively analyzed, among which 14 patients were arranged for combined lateral and medial approach, 12 for lateral approach, and 12 for anterior medial approach. All included patients underwent open reduction, collateral ligament repair, and postoperative function exercise. Follow-up was conducted for 13~22 months. The elbow motion, excellent and good rate, healing time, and complication rate were recorded and compared. RESULTS These 3 approaches significantly improved the postoperative elbow motion, MEPS, VAS, excellent and good rate, and open reduction (all P<0.05). The VAS score for lateral approach was evidently higher than that for combined lateral and medial approach (P<0.05). Combined lateral and medial approach and anterior medial approach had better performance on elbow motion, MEPS, and excellent and good rate than lateral approach (both P<0.05). Lateral approach and anterior medial approach had a significantly reduced healing time compared with combined lateral and medial approach (both P<0.05), while anterior medial approach had a higher complication rate compared with anterior medial approach and lateral approach (both P<0.05). CONCLUSIONS Lateral combined medial surgery approach contributes to wide surgical exposure, facture stability, and decreased complication rate, and thus has superior efficacy than the other 2 surgical approaches.

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Figures

Figure 1
Figure 1
The preoperative and postoperative CT image for a representative patient who underwent combined lateral and medial surgical approach (A, anteroposterior radiograph before surgery; B, anteroposterior radiograph after surgery).
Figure 2
Figure 2
The preoperative and postoperative CT image for a representative patient who underwent lateral surgical approach (A, anteroposterior radiograph before surgery; B, anteroposterior radiograph after surgery).
Figure 3
Figure 3
The preoperative and postoperative CT image for a representative patient who underwent anterior medial surgical approach (A, anteroposterior radiograph before surgery; B, anteroposterior radiograph after surgery).
See this image and copyright information in PMC

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