The Journal of Bone and Joint Surgery (American). 2008;90:75-84.
doi:10.2106/JBJS.H.00893
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Management of Unstable Elbows Following Complex Fracture-Dislocations—the "Terrible Triad" Injury

Gregory J. Zeiders, DO1 and Minoo K. Patel, MBBS, MS, FRACS2

1 Oklahoma State University, Oklahoma Sports Science and Orthopaedics, 6205 North Santa Fe, Suite 200, Oklahoma City, OK 73118. E-mail address: gjz@okss.com
2 Monash University and Monash Medical Centre, Centre for Limb Lengthening and Reconstruction, Suite 5.7, The Epworth Centre, 32 Erin Street, Richmond, VIC 3121, Australia. E-mail address: minoo.patel@bigpond.com

The first 150 words of the full text of this article appear below.


   Introduction
 
Complex fracture-dislocations of the elbow can often be either irreducible or unstable, with an inability to hold the reduction or with the delayed development of subluxation or dislocation. The aim of the present study was to evaluate the etiology of the instability, both osseous and ligamentous, and the results of stabilization with a combination of internal fixation, ligament repair, radial head arthroplasty and, when necessary, hinged external fixation. Figures 1 and 2 represent our formulated protocol and treatment algorithm for elbow fracture-dislocation in this series of thirty-two patients.


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  		Fig. 1 Constellation of the "terrible triad" injury and the anatomic structures encountered. LUCL = lateral ulnar collateral ligament, and MUCL = medial ulnar collateral ligament.

 

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  		Fig. 2 Treatment algorithm proposed for the achievement of anatomic fixation and mechanical stability in patients with complex fracture-dislocations of the elbow. EUA = examination under anesthesia, MUCL = medial ulnar collateral ligament, LUCL = lateral ulnar collateral ligament, P/L . . . [Full Text of this Article]

 

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