TY - JOUR
T1 - Results of terrible triads in the elbow
T2 - The advantage of primary restoration of medial structure
AU - Jeong, Woong Kyo
AU - Oh, Jong Keon
AU - Hwang, Jin Ho
AU - Hwang, Seok Min
AU - Lee, Won Seok
PY - 2010/9
Y1 - 2010/9
N2 - Background: The purpose of this study was to report the clinical and radiological outcomes and surgical strategy for terrible triad injury of the elbow. We hypothesized that the outcomes of this type of injury would be satisfactory if the medial structure was routinely restored at the same time as the repair of the lateral structure. Methods: We retrospectively reviewed the results of this treatment performed in 13 elbows with terrible triads. Our surgical protocol included fixation or replacement of the radial head and repair of the ruptured lateral ulnar collateral ligament through the lateral traumatic window. In all cases, simultaneous fixation of the coronoid and repair of the common flexor muscle were performed through the medial traumatic window. In eight patients with medial collateral ligament injury, the ligament was always repaired. The follow-up period ranged from 18 to 41 months (mean, 25 months). Results: The flexion-extension arc of the elbow averaged 128° and forearm rotation averaged 134.6°. The mean Mayo elbow performance score was 95 points (range, 85 to 100), which corresponded to ten excellent results, and three good results. Concentric stability was restored to all cases. As postoperative complications, one patient had ulnar nerve neuropathy. Conclusions: The present operative procedures restoring all damaged lateral and medial structures through the lateral and the medial windows provided satisfactory clinical and radiological outcomes and are recommended for patients with terrible triad injury.
AB - Background: The purpose of this study was to report the clinical and radiological outcomes and surgical strategy for terrible triad injury of the elbow. We hypothesized that the outcomes of this type of injury would be satisfactory if the medial structure was routinely restored at the same time as the repair of the lateral structure. Methods: We retrospectively reviewed the results of this treatment performed in 13 elbows with terrible triads. Our surgical protocol included fixation or replacement of the radial head and repair of the ruptured lateral ulnar collateral ligament through the lateral traumatic window. In all cases, simultaneous fixation of the coronoid and repair of the common flexor muscle were performed through the medial traumatic window. In eight patients with medial collateral ligament injury, the ligament was always repaired. The follow-up period ranged from 18 to 41 months (mean, 25 months). Results: The flexion-extension arc of the elbow averaged 128° and forearm rotation averaged 134.6°. The mean Mayo elbow performance score was 95 points (range, 85 to 100), which corresponded to ten excellent results, and three good results. Concentric stability was restored to all cases. As postoperative complications, one patient had ulnar nerve neuropathy. Conclusions: The present operative procedures restoring all damaged lateral and medial structures through the lateral and the medial windows provided satisfactory clinical and radiological outcomes and are recommended for patients with terrible triad injury.
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U2 - 10.1007/s00776-010-1515-8
DO - 10.1007/s00776-010-1515-8
M3 - Article
C2 - 20953921
AN - SCOPUS:78149459498
SN - 0949-2658
VL - 15
SP - 612
EP - 619
JO - Journal of Orthopaedic Science
JF - Journal of Orthopaedic Science
IS - 5
ER -