Risk factors of efficacy for patients receiving surgical treatment following terrible triad of the elbow joint: A comparative study

Abstract

Background: This study aims to explore the efficacy of surgical and conservative treatment for elbow joint terrible triad, and evaluate related factors affecting surgical treatment efficacy.

Methods: Patients with terrible triad of elbow joint (n = 165) were selected, among which 79 cases underwent conservative treatment (the control group) and 86 cases underwent surgical treatment (the experimental group). The range of flexion and extension, range of rotation and Mayo elbow performance score were recorded. In the experimental group, postoperation, according to the Mayo elbow performance score, patients were assigned into the effective group (72 cases) and ineffective group (14 cases). All patients were followed up regularly for 6 to 24 months. X-ray and computed tomography examination were used to examine anterior and posterior elbow joints preoperatively and postoperatively and the degree of arm rotation.

Results: The range of flexion and extension, range of rotation and Mayo elbow performance score were found to be significantly higher in the experimental group after treatment compared to the experimental group before treatment and in the control group after treatment. Seven days after treatment, compared with the control group, the expressions of interleukin (IL)-6, C-reactive protein, IL-8, and tumor necrosis factor-α in serum decreased, and returned to almost near normal levels in the experimental group. Age, mean operative time, and postoperative immobilization time were significantly different between the effective and ineffective groups. The incidence of joint stiffness, heterotopic ossification, and ulnar nerve symptoms in the effective group were lower than those in the ineffective group. The postoperative immobilization time served a protective factor for the efficacy of surgical treatment of elbow joint terrible triad, while age served as a risk factor.

Conclusion: The results indicated that surgical treatment regimens for elbow joint terrible triad exhibited better efficacy than conservative treatment regimens, and lower age and longer postoperative immobilization time serve as protective factors for surgical treatment efficacy.

Figure 1

Fracture site of elbow joint in the experimental and control groups. (A) Postoperative frontal and lateral X-ray of elbow joint in the experimental group. (B) Postoperative frontal and lateral X-ray of elbow joint in the control group.