Terrible than terrible triad of elbow

The brachial artery is rarely injured in closed posterior dislocation, despite the anatomical proximity.Most cases of brachial artery injury after dislocation of the elbow are associated with fracture. The neurovascular examination that comprises checking for the distal pulse is mandatory, and the absence of the same is considered a warning sign. Investigations like doppler and arteriography should be done to prevent potential complications. Our study is about a patient with closed posterior dislocation with vascular insufficiency in the left ulnar and Radial artery due to following self-fall from a 2-wheeler. We treated her with Tissue reconstruction on the medial and lateral sides, including UCL and Common Flexor Origin and repaired LCL and Common extensor origin with Thrombectomy. At six months follow-up, no complications of vascular injury were noted.