treatment of the “terrible triad of the elbow”. Clin Orthop Relat Res. The goal of treatment for terrible triad injuries is restoring the bony anatomy and reconstructing the ligamentous restraints of the elbow to provide enough stability for early elbow … Fixation versus replacement of radial head in terrible triad: is there a difference in elbow stability and prognosis? Copyright © 2015 Elsevier Ltd. All rights reserved. Eventually, my progress in physical therapy came to a stop. Figure 1. Figure 1. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V.  |  results (77–100%) from surgical treatment of the terrible triad of the elbow, in accordance with the protocol presented by Pugh et al.6–14 This study had the objective of evaluating the clinical and radiographic results from patients with the terrible triad of the elbow who were operated in accordance with this pro-tocol. Understands how to avoid/prevent potential complications . Laith M. Jazrawi, MD Associate)Professor)of)Orthopaedics Chief)2)Division)of)Sports)Medicine) Tel:)(646)50127223)! Knee. Standardized surgical protocol for terrible triad injury. 2: Mathew PK, Athwal GS, King GJ. J Am Acad Orthop Surg. Treatment strategy of terrible triad of the elbow: experience in Shanghai 6th People's Hospital. Terrible triad injury of the elbow: current . Elbow Trauma Rehabilitation Protocol Includes post ORIF, or conservatively managed trauma when active ROM indicated N.B. 4. The terrible triad of the elbow causes extensive damage to the ligaments and osseous structures, which provides acute elbow stability. The thing that took the longest to recover was the extension and flexion of my elbow joint. Lateral Ulnar Collateral Ligament Repair/Reconstruction Protocol. This leads to new injuries. Clin Shoulder Elb. The steps involved in surgical management are presented as an algorithm in Figure 5. The term “terrible triad” was coined by Hotchkiss [] in 1996 to describe an injury complex that consisted of a dislocated elbow along with radial head and coronoid fractures. Liu G, Ma W, Li M, Feng J, Xu R, Pan Z Medicine (Baltimore) 2018 Apr;97(16):e0523. We use cookies to help provide and enhance our service and tailor content and ads. In addition there is rupture of the lateral and medial collateral ligaments. Mazen Ali Department of Orthopedic Surgery and Trauma, Regional Hospital of Orleans, Orleans, France. Protection of the ligament repair is essential. In addition there is rupture of the lateral and medial collateral ligaments. Knee Arthroscopy and Partial Meniscectomy or Loose Body Removal. Would you like email updates of new search results? Int Orthop. Outcomes after terrible triads of the elbow treated with the current surgical . Elbow dislocation; Hinged external fixator; Instability; Terrible triad. 2020 Jul;8(3):207-208. doi: 10.30476/BEAT.2020.86013. An elbow dislocation associated with a radial head and coronoid fractures is termed a terrible triad. Fracture-dislocations of the elbow remain among the most difficult injuries to manage. Objective Terrible triad injury of the elbow (TTIE), comprising elbow dislocation with radial head and coronoid process fracture, is notoriously challenging to treat and has typically been associated with complications and poor outcomes. This study aimed to describe the functional results and prognostic factors of surgery in patients with STT. The short-term and long term results are historically poor, with a … Lateral Epicondylitis (Tennis Elbow) Post-operative Rehab. Bull Emerg Trauma. 2014 Jun;45(6):942-8. doi: 10.1016/j.injury.2013.12.012. eCollection 2020 Jun. Copyright © 2021 Elsevier B.V. or its licensors or contributors. resent our formulated protocol and treatment algorithm for el-bow fracture-dislocation in this series of thirty-two patients. Epub 2014 Jan 10. A terrible triad injury refers to a posterior dislocation of the elbow associated with radial head and coronoid process fractures. Complex dislocations are generally treated with surgery, usually within 24 hours if the fracture is comminuted or unstable (2). 2011 Jun;35(6):851-60. 2014 Jul;472(7):2128-35. doi: 10.1007/s11999-013-3331-x. strengthening protocol after 6 weeks; Operative. The short-term and long term results are historically poor, with a high rate of complications. In order for it to ... Generally these should commence around day 7-10 for a terrible triad or elbow dislocation unless otherwise specified in the operating report. Saini UC, Neradi D, Kumar D, Bacchal V, Sodavarapu P, Shetty A. The “terrible triad of the elbow” is a notorious combination of elbow dislocation and fractures of the coronoid process and radial head that has historically been difficult to manage and had an unsatisfactory prognosis 36-38, almost unavoidably causing long‐standing postoperative pain, elbow instability and a range of complications. The surgeon should attempt to restore stability by preserving the radial head whenever possible or replacing it with prosthesis otherwise, by repairing the lateral collateral ligament and performing fixation of the coronoid fracture. Author information: (1)Trauma and Orthopaedics, Shoulder and Elbow Unit, Infanta Leonor Hospital, 28031 Madrid, Spain. Background- This study is to report our experience in the management of terrible triad injury of the elbow and to validate the therapeutic choices of our treatment. 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.. Copyright © 2015 Elsevier Ltd. All rights reserved. lated terrible triad injury, when re-sidual instability was present after LCL repair and radial head repair or arthroplasty, repair of the MCL was more effective than fixation of small coronoid fractures in restoring elbow stability.15 In clinical series of terrible triad injuries, most … Epub 2010 May 8. Review. We retrospectively review the results of surgical treatment of eighteen terrible triads from a multicentre study of 226 elbow dislocations. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Patella or Quadriceps Tendon Repair Rehab Protocol 2013 Apr;27(4):496-9. The terrible triad of the elbow causes extensive damage to the ligaments and osseous structures, which provides acute elbow stability. -Splint to be worn full time except for when performing therapy exercises for the "rst 6 weeks. Most terrible triad elbow injuries are managed surgically.  |  Terrible triad injuries of the elbow: does the coronoid always need to be fixed? Meena MK, Singh K, Meena S, Kumbhare C, Chouhan D. Bull Emerg Trauma. Methods: Eight patients identified with “terrible triad” injury patterns, including posterior elbow dislocation, radial head fracture and coronoid fracture, were available for a minimum of 11 months follow-up. 2014 Jul;472(7):2084-91. doi: 10.1007/s11999-014-3471-7. Terrible triad of the elbow: treatment protocol and outcome in a series of eighteen cases. Figure 5: Twenty-six patients with elbow stiffness after operation of terrible triad injury of the elbow were treated with our protocol. The so-called “terrible triad” involves a posterior dislocation with both a radial head and coronoid process fracture and often has less optimal outcomes (2). National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Background- This study is to report our experience in the management of terrible triad injury of the elbow and to validate the therapeutic choices of our treatment. The terrible triad is an uncommon injury, which includes an elbow posterior dislocation with fractures of the radial head and coronoid process of the ulna. The purpose of this study is to report the outcomes of a modification of the standard surgical protocol for the repair of terrible triad of the elbow injuries. The shoulder terrible triad (STT) is a traumatic anterior shoulder dislocation, associated with rotator cuff (RC) tear and nerve injury from the brachial plexus. concepts. BACKGROUND: Terrible triad of the elbow can be a challenging injury to treat, with a history of well-known complications. protocols. 2011 Jun;35(6):851-60. Surgical technique. 1; Elbow Terrible Triad ORIF. When the patient is deemed medically fit, surgery is indicated for failure to meet nonsurgical treatment criteria, for open wounds, and/or for neurologic or vascular injury. NIH concepts. 2005 Mar;87 Suppl 1(Pt 1):22-32. doi: 10.2106/JBJS.D.02933. Clin Orthop Relat Res. Comminuted Radial Head Fracture in All-arthroscopic Repair of Elbow Fracture-dislocation: Is Partial Excision of the Radial Head an Acceptable Treatment Option? Orthobullets Team % TECHNIQUE VIDEO 0 % TECHNIQUE STEPS ... revise therapy 3. 2020 Jul;8(3):209. doi: 10.30476/BEAT.2020.86026. Anterior Cruciate Ligament (ACL) Reconstruction Rehab Protocol. A review. For terrible triads, or ORIF + ligament reconstruction, please also refer to ligament repair protocols. The terrible triad is an uncommon injury, which includes an elbow posterior dislocation with fractures of the radial head and coronoid process of the ulna. 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