Elbow terrible triad: Advancing current concepts in the treatment of 13 cases

Q4 Medicine

Trauma Case Reports Pub Date : 2025-02-24 DOI:10.1016/j.tcr.2025.101146

Edgar Barros Prieto , Eduardo Noboa , Carlos Ballesteros , Carlos Peñaherrera , Francisco Endara , Alejandro Barros Castro

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引用次数: 0

Abstract

Background

The “terrible triad” of the elbow is characterized by a combination of elbow dislocation with fractures of the radial head and the coronoid process of the ulna. This injury is notoriously complex due to the rupture of key elements that ensure elbow stability, resulting in poorer outcomes compared to simpler joint injuries. Despite advances in treatment protocols, an optimal surgical approach and fixation technique standard have not yet been established.

Methods

This descriptive study focused on reviewing the anatomical and clinical characteristics of the elbow joint, considering the most current biomechanical concepts. Management protocols implemented in our practice were evaluated, including specific surgical techniques and fixation methods based on a deep understanding of elbow anatomy and biomechanics. Retrospective data were collected from patients treated at our centers, analyzing postoperative clinical and radiographic outcomes.

Results

The implementation of a treatment based on updated concepts of elbow biomechanics and anatomy showed a significant improvement in postoperative joint stability and functional recovery of patients. There was a reduction in complication rates and an improvement in clinical outcomes compared to traditional approaches. The selection of specific fixation techniques and surgical approaches allowed for more effective management of the “terrible triad,” adapting to the particularities of each case and optimizing results.

Conclusion

This study highlights the importance of a detailed understanding of elbow biomechanics and anatomy for the effective management of the “terrible triad.” The implementation of protocols based on these principles can significantly improve clinical outcomes and reduce complications, offering a comprehensive approach to addressing this complex pathology.

Level of Evidence: IV

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肘可怕三联征：推进现行观念治疗13例

肘关节“可怕三联征”的特征是肘关节脱位合并桡骨头骨折和尺骨冠突骨折。由于确保肘关节稳定性的关键因素断裂，这种损伤非常复杂，与简单的关节损伤相比，结果更差。尽管治疗方案取得了进步，但尚未建立最佳的手术入路和固定技术标准。方法本描述性研究的重点是回顾肘关节的解剖和临床特征，并考虑到最新的生物力学概念。我们评估了在我们的实践中实施的管理方案，包括基于对肘部解剖和生物力学的深刻理解的特定手术技术和固定方法。回顾性收集在我们中心治疗的患者的资料，分析术后临床和影像学结果。结果基于最新肘部生物力学和解剖学概念的治疗方法的实施显著改善了患者术后关节稳定性和功能恢复。与传统方法相比，并发症发生率降低，临床结果改善。选择特定的固定技术和手术入路可以更有效地处理“可怕的三联征”，适应每个病例的特殊性并优化结果。结论：本研究强调了详细了解肘部生物力学和解剖学对有效治疗“可怕三联征”的重要性。基于这些原则的方案的实施可以显著改善临床结果并减少并发症，为解决这一复杂的病理提供了一种全面的方法。证据等级：四级

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.