Abstract:

BACKGROUND: The previous treatment of elbow dislocations associated with radial head and coronoid fractures (terrible triad of the elbow) are often poor because of recurrent instability, stiffness and other complications from prolonged immobilization.
OBJECTIVE: To observe the clinical efficacy on treatment of the terrible triad of the elbow with hinged elbow external fixator with limited internal fixation.
METHODS: A total of 14 cases received the terrible triad of the elbow treatment from April 2006 to June 2010 at Foshan Hospital of Traditional Chinese Medicine, were collected. The patients were treated with metal hinged elbow external fixator combined with pin and screw fixation. All patients were followed up for ≥ 5 months, complained of illness, elbow range of motion, the forearm rotating activity, joint stability and radiographs were recorded. Mayo Elbow Performance Score (MEPS) was used to evaluate the function of elbow.
RESULTS AND CONCLUSION: No patient complained pain, instability and no superficial and deep tissue infections occurred at the last follow-up. The mean fracture healing time was (11.30±3.25) weeks. The average range of elbow flexion-extension were (125.42±19.66) ° (75°-145°), and forearm pronation-supination were (135.43±17.07) ° (80°-150°). Two cases of brain injury occurred a small amount of ossification in anterior cubital soft tissue, did not affect the joint motion. The functional outcome was excellent in 7, good in 5 and fair in 2 according to MEPS, the fine and good rate was 86%. Hinged elbow external fixator combined with pins and screw fixation can improve the initial stability, conducive to the elbow of the center of concentric reduction and soft tissue repair and facilitate early functional exercise, eliminate the problem of secondary surgery.