Objective To explore the operation procedure and effectiveness of terrible triad of the elbow joint. Methods Between October 2006 and June 2010, 11 cases of closed terrible triad of the elbow joint were treated by operation. There were 8 males and 3 females with an average age of 32 years (range, 21-53 years). The mechanism of injury was fall ing from height in 4 cases and traffic accident in 7 cases. The time from injury to admission was 30 minutes to 9 days. According to Regan-Morrey classification for fractures of the ulnar coronoid, there were 5 cases of type I, 5 cases of type II, and 1
case of type III; and according to Mason classification for fractures of the radial head, there were 4 cases of type I, 5 cases of type II, and 2 cases of type III. The elbow joint range of motion (ROM) was (63 ± 9)° at flexion and extension, and the forearm ROM was (71 ± 8)° at pronation and supination. All cases underwent reduction and fixation by lateral approach combined with medial approach according to McKeeps operation process. After operation, the affected l imb was immobil ized with plaster at elbow joint flexion of 90° and in forearm neutral position, then passive physical exercises were carried out, and finally active physical exercises were done after removing plaster at 4 weeks. Results All incisions healed by first intention. Eleven cases were followed up 7-27 months (14.5 months on average). The X-ray films showed good reduction, the cl inical heal ing time was 8-19 weeks with an average of 11 weeks. Mild ectopic ossification of the elbow joint occurred in 3 cases at 6 months after operation, mild degenerative change in 1 case at 18 months after operation. At last follow-up, the elbow joint ROM was (103 ± 14)° at flexion and extension, and the forearm ROM was (122 ± 13)° at pronation and supination, showing no significant difference when compared with the values of normal elbow joint (P gt; 0.05) and significant difference when compared with the preoperative values of affected elbow joint (P lt; 0.05). According to Mayo elbow performance score, the results were excellent in 5 cases, good in 5 cases, and fair in 1 case with an excellent and good rate of 90.9%. Conclusion The surgical treatment of terrible triad of the elbow joint can restore sufficiently elbow stabil ity, allow early motion postoperatively, and enhance the functional outcome.
Citation： KUANG Xinjian,CAI Hang,BAO Feng,HUANG Hongbin,GONG Jianghao,LOU Yongjian,CHEN Xuhong.. OPERATIVE TREATMENT OF TERRIBLE TRIAD OF THE ELBOW JOINT. Chinese Journal of Reparative and Reconstructive Surgery, 2011, 25(8): 964-967. doi: Copy