J Am Acad Orthop Surg. Epub 2010 May 8. Review. Management of Terrible Triad Injury of the Elbow and their Functional Outcomes @inproceedings{Kulkarni2015ManagementOT, title={Management of Terrible Triad Injury of the Elbow and their Functional Outcomes}, author={V. Kulkarni and Sagar Saxena and S. Kulkarni and P. Shah and Priyanshu Dixit and Pradhyumn Rathi}, year={2015} } Management of Terrible Triad Injury of the Elbow and their Functional Outcomes. Epub 2010 May 8. Review. Management of elbow stiffness after postoperative treatment of terrible triad elbow injury: maintaining mobility and stability using a combined protocol. @article{Pipicelli2011RehabilitationCI, title={Rehabilitation considerations in the management of terrible triad injury to the elbow. The goal of this study is to evaluate our clinical results after medial capsulo-ligamentar plan reinsertion, radial head replacement and lateral collateral ligament reinsertion, through a lateral approach. Successful management of complex elbow fracture-dislocations requires, in part, recognition of the overall injury pattern, which can aid in the identification of concomitant bony and soft tissue injuries. our knowledge of elbow instability and its management. Equipment. The terrible triad of the elbow is a difficult injury with historically poor outcomes. 3: … [3] They more commonly occur in adult men, with a peak incidence during the 4th decade of life. 2011 Jun;35(6):851-60. Share. The term “terrible triad of the elbow” describes the combination of a traumatic elbow dislocation, radial head fracture, and associated coronoid fracture. Elbow dislocation associated with both radial head and coronoid fractures, termed the “terrible triad injury” (TTI) by Hotchkiss [1], was notoriously challenging for decades because of the difficulties inherent in treatment and the consistently poor prognosis [2-4]. Terrible triad of the elbow and the Essex-Lopresti injury are both rare lesions with a historically poor clinical outcome. Main indications. In non-displaced fractures, splint for 5-7 days, remove and repeat X-ray to confirm non-displacement. A review. This is useful from a number of standpoints: it improves the patient's pain, reduces tension on soft-tissue structures, decreases swelling, and allows for postreduction radiographs that are usually easier to interpret and base treatment decisions on. 'Terrible triad' is a term used to describe a severe complex dislocation with intra-articular fractures of the radial head and coronoid process. Refer displaced fractures for surgery. Terrible triad injury of the elbow: current . 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. Management of Terrible Triad Injuries of the Elbow The Duke Orthopaedic Journal, July 2014-June 2015;5(1):28-34 29 DOJ the body internally rotates about the hand. concepts. Authors of section Editors. [MODIFIED CLASSIFICATION AND MANAGEMENT OF TERRIBLE TRIAD OF ELBOW]. Skill level. Elbow instability adam watts 1. Corpus ID: 31597300. Management of a fracture-dislocation injury of the elbow is difficult and usually associated with a high rate of complications. Peter Kloen, David Ring. Strategies for management of a terrible triad. 1 Tyler Vovos MS, 2 Daniel J Blizzard MD MS, 3 Grant Garrigues MD. 2: Mathew PK, Athwal GS, King GJ. PubMed PMID: 19264707. Management of Terrible Triad Injuries of the Elbow . The terrible triad is the combination of a posterior dislocation of the elbow, radial head and coronoid process fractures. Vidisha S Kulkarni, Sagar Saxena, Sunil G Kulkarni, Parag Shah, Priyanshu Dixit, Pradhyumn Rathi Abstract 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. Select Management. Definite treatment protocols may improve the clinical results of such complex injuries. The coronoid plays a pivotal role as an anterior buttress, yet the optimal management of the coronoid fracture remains unknown. Terrible triad injuries account for approximately 30% of all elbow dislocations. 2009 Mar;17(3):137- 51. Review. Int Orthop. Peter Trafton, Michael Baumgaertner. Characteristics/Clinical Presentation Rehabilitation considerations in the management of terrible triad injury to the elbow. Open all credits. lea in the coronal plane, hinging on the lateral collateral liga­ ment (Figure 2). }, author={J. Pipicelli and S. Chinchalkar and R. Grewal and G. Athwal}, journal={Techniques in hand & … PubMed PMID: 20449590; PubMed Central PMCID: PMC3103950. OBJECTIVE: To investigate the feasibility of modified classification of terrible triad of the elbow and the effectiveness of treatment strategy which was chosen by modified classification results. Outcomes after terrible triads of the elbow treated with the current surgical . The mechanism of injury usually involves a fall with the arm in semiflexion, supination of the forearm and an elbow in a valgus position (1). The “terrible triad injury” of the elbow, as named by Hotchkiss, is the combination of an elbow dislocation, a radial head fracture and a coronoid process fracture The main objective in the management of such injuries is to restore the stabilizing bony structures of the elbow to convert a complex dislocation of the elbow joint into a simple one. MCL avulsion is likely to be present in many terrible triad injuries, and there is no consensus as to the need for a medial exposure in a terrible triad injury. Management. An elbow dislocation associated with a radial head and coronoid fractures is termed a terrible triad. 2011 Jun;35(6):851-60. Concurrent ipsilateral injuries to the wrist, interosseous membrane of the forearm, and shoulder have been described. Terrible triad of the Elbow 1. Skill level. Immobilise the elbow in a long arm posterior splint with the elbow in 60-90° flexion, well moulded posteriorly. Cui HM(1), Yu YL(1), He Y(2), Cheng Y(1), Liu JZ(1)(3), Zheng W(1), Chen S(1), Fan CY(4). For terrible triads, or ORIF + ligament reconstruction, please also refer to ligament repair protocols. The primary goal of surgery is to stabilize the elbow to permit early motion to prevent stiffness. The terrible triad of the elbow remains a challenging injury that consists of a dislocation of the elbow with fractures of the radial head and coronoid process of the ulna. Main indications. Luckily, elbow specialists have come up with sound strategies to restore the best possible stability and function to the elbow joint after a terrible triad. Elbow Trauma Rehabilitation Protocol Includes post ORIF, or conservatively managed trauma when active ROM indicated N.B. Initial management of the “terrible triad” should consist of a gentle closed reduction under intravenous sedation or general anesthesia. Legend Definition skills and equipment level. 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. Materials And Methods: … Trans-olecranon fracture-dislocations are best treated surgically with stable anatomic restoration of the trochlear notch. Outcomes after terrible triads of the elbow treated with the current surgical . PubMed PMID: 20449590; PubMed Central PMCID: PMC3103950. A review. Background: Terrible triad injuries of the elbow are complex injuries to treat and we report our outcomes following surgical management. [ 3 – 8 , 25 ] Pugh et al [ 3 ] repaired the MCL in 6 (17%) of 36 patients with terrible triad elbow injuries, and only in cases where the patients showed residual posterior instability after repair. Protection of the ligament repair is essential. DOI: 10.1097/BTH.0b013e31822911fd Corpus ID: 34529086. Executive Editors. 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