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Terrible triad

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https://www.readbyqxmd.com/read/29668642/operative-treatment-of-terrible-triad-of-the-elbow-with-a-modified-pugh-standard-protocol-retrospective-analysis-of-a-prospective-cohort
#1
Guanyi Liu, Weihu Ma, Ming Li, Jianxiang Feng, Rongming Xu, Zhijun Pan
The aim of the present study was to investigate the efficacy of the surgical treatment of terrible triad injuries of the elbow using a modified standard surgical approach, and treatment determined by the mode and mechanism of injury, and intraoperative findings.The study was a retrospective analysis of a prospective cohort of patients presenting with terrible triad injuries of the elbow, who underwent surgical treatment between July 2009 and January 2014. All patients were treated surgically according to a modified Pugh standard protocol...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29664804/temporary-bridge-plate-stabilization-of-unstable-elbow-fractures-and-dislocations
#2
David Edelman, Asif M Ilyas
Unstable fracture-dislocations of the elbow, and in particular the "terrible triad" injury consisting of an elbow dislocation with a fracture of the radial head and coronoid, are complex injuries that can be plagued and complicated by persistent instability. Acute and chronic instability is a difficult problem and is best managed early by avoidance and restoration of stability. A number of treatment options have been proposed to manage acute postfixation instability of the elbow joint. Traditional stabilization options include immobilization with splinting or casting, cross-articular pinning, and external fixation (hinged or static), followed by early physical therapy...
April 11, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29375261/terrible-triad-of-the-elbow-functional-results-of-surgical-treatment
#3
Roberto Yukio Ikemoto, Joel Murachovsky, Rogério Serpone Bueno, Luis Gustavo Prata Nascimento, Adriano Bordini Carmargo, Vitor Elias Corrêa
Objective: To evaluate the functional and radiographic results of patients who underwent surgical treatment for terrible triad-type elbow injuries (TTE). Methods: We retrospectively evaluated 20 patients, including one case with bilateral injuries (total of 21 elbows) that were surgically treated from January 2004 to July 2014. We evaluated the functional results of treatment by measuring the restored range of motion (ROM) of the elbow, using the DASH (Disabilities of the Arm, Shoulder and Hand) and MEPS (Mayo Elbow Performance Score) scores...
November 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/29367033/comparison-of-a-single-approach-versus-double-approaches-for-the-treatment-of-terrible-traid-of-elbow-a-retrospective-study
#4
Chengwei Zhou, Jianxiang Xu, Jinti Lin, Renjin Lin, Kai Chen, Jianzhong Kong, Yongzeng Feng, Xiaolong Shui
INTRODUCTION: Dislocation of the elbow associated with radial head and coronoid fracture, the so-called "terrible triad" of the elbow, is challenging to treat and has a history of complicated outcomes. This study is to compare the clinical outcome of a single lateral approach-the extensile splitting extensor digitorum communis (EDC) approach and combined lateral and medial (CML) approaches for the treatment of terrible traid of the elbow (TTE). MATERIAL AND METHODS: After appropriate exclusion, 60 TTE patients (28 patients in the EDC group, 32 patients in the CML group) from 2009 January to 2015 August were reviewed in this study...
March 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29327556/-surgical-treatment-for-the-fractures-and-dislocations-of-the-elbow-in-old-patients
#5
Hua Xu, Li-Feng Shen, Hua-Jun Yu, Xiao-Wen Zhang, Qiao-Feng Guo
OBJECTIVE: To introduce and report the preliminary results of 7 old patients with fractures and dislocations of the elbow. METHODS: From July 2011 to August 2015, 7 old patients suffered from fractures and dislocations of the elbow(5 of which were terrible triad). One patient had type Iradial head fracture, 3 type IIand 1 type III according to the Mason classification, and 1 type I, 5 type IIand 1 type III according to the Regan-Morrey classification. All the 7 patients received operation and then were treated with external fixation...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29288378/management-of-elbow-stiffness-after-postoperative-treatment-of-terrible-triad-elbow-injury-maintaining-mobility-and-stability-using-a-combined-protocol
#6
Hao-Min Cui, Ya-Ling Yu, Yu He, Yuan Cheng, Jia-Zhi Liu, Wei Zheng, Shuai Chen, Cun-Yi Fan
PURPOSES: The purpose of this study was to evaluate the results of our protocol that include the restoration of mobility using open release combined with external fixation and stability using ligament repair, to determine the optimal timing of surgery, and to investigate whether resection and replacement of the radial head are associated with different outcomes. METHODS: Twenty-six patients with elbow stiffness after operation of terrible triad injury of the elbow were treated with our protocol...
March 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29098354/-total-elbow-arthroplasty-in-traumatic-and-post-traumatic-bone-defects
#7
REVIEW
M Hackl, L P Müller, T Leschinger, K Wegmann
Total elbow arthroplasty is currently most commonly carried out due to acute trauma or post-traumatic conditions. Bone defects are often present and must be considered in the (pre-)operative workup. The use of semi-constrained prostheses with a systematic cementing technique through a triceps-on approach leads to satisfying clinical results, however, the outcome is worse when compared with rheumatic patients.Primary total elbow arthroplasty for complex distal humerus fractures in the elderly patient or secondary implantation following failed conservative treatment or osteosynthesis represent possible indications for (post‑)traumatic joint replacement...
December 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28913386/persistent-medial-subluxation-of-the-ulna-with-radiotrochlear-articulation
#8
Amir R Kachooei, David Ring
Two patients-one with a terrible triad fracture dislocation and one with an anterior olecranon fracture dislocation-were treated for maltracking of the elbow (medial subluxation). The radial head articulated with the lateral trochlea while the ulnar trochlear notch was perched over the medial trochlea. The late revision surgery could not correct the subluxation because the joints were accustomed to the new alignment, however the overall function was reasonable.
July 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28734536/evaluation-of-functional-outcome-after-nonsurgical-management-of-terrible-triad-injuries-of-the-elbow
#9
Farid Najd Mazhar, Davod Jafari, Alireza Mirzaei
BACKGROUND: Terrible triad (TT) is one of the severe injuries of the elbow that generally requires surgery. Nonsurgical treatment has recently been applied in selected cases of TT injury. Evaluation of the results of this treatment was the main aim of this study. METHODS: In a prospective cohort study, 10 patients with a mean follow-up of 30.6 months were evaluated. The inclusion criteria included a congruent joint after closed reduction, no indication for surgery of the coronoid and radial head fractures, no block in supination and pronation up to 60°, no intra-articular fragments, and a free and stable joint with ulnohumeral extension up to a minimum of 45°...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28634742/outcomes-of-coronoid-first-repair-in-terrible-triad-injuries-of-the-elbow
#10
Junren Zhang, Mark Tan, Ernest Beng Kee Kwek
BACKGROUND: Clinical outcomes of terrible triad injuries (TTIs) of the elbow are historically poor. To date, it is still debatable whether the coronoid needs to be fixed and if so, how and in which sequence. METHODOLOGY: Between 2010 and 2013, 13 patients were treated surgically for acute TTIs of the elbow at a Tertiary Level 1 Trauma Centre by a single surgeon, using a standardized protocol, which included coronoid-brachialis complex fixation via pull-through trans-osseous sutures, radial head fixation or prosthetic replacement and a repair of the lateral ulnar collateral ligament...
September 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28562532/evaluation-of-a-combined-posterior-lateral-and-anteromedial-approach-in-the-treatment-of-terrible-triad-of-the-elbow-a-retrospective-study
#11
RANDOMIZED CONTROLLED TRIAL
Hong-Wei Chen, Zi-Yang Wang, Xulin Wu, Bensen Tang, Weimin Zhu, Guangfu Zhou, Fuyao Liu, Bing Qiu
BACKGROUND: This retrospective study aims to investigate the efficacy and safety of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow (TTE). METHODS: TTE patients who received a combination of posterior lateral and anteromedial approach or other conservative treatments were included in the present study. The postoperative functions of the elbow and the severity of traumatic arthritis were assessed using the Mayo Elbow Performance Score (MEPS) and visual analog scale (VAS)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28549892/radial-head-arthroplasty-in-the-active-duty-military-service-member-with-minimum-2-year-follow-up
#12
John C Dunn, Nicholas A Kusnezov, Logan R Koehler, Emmanuel D Eisenstein, Kelly G Kilcoyne, Justin D Orr, Justin S Mitchell
PURPOSE: Radial head arthroplasty (RHA) is a viable treatment for complex radial head fracture. Whereas elbow stability and function is typically restored at short- to mid-term follow-up, the outcome in higher-demand populations is not well defined. We sought to characterize the functional and occupational outcomes following RHA in an active duty military population with intense upper extremity demands. METHODS: We retrospectively reviewed the records of all U.S...
August 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28499246/evaluation-of-the-therapeutic-effects-of-lateral-approach-combined-with-anteromedial-approach-in-the-treatment-of-terrible-triad-of-the-elbow
#13
Hong-Wei Chen, Zi-Yang Wang, Geng-Sheng Wei
OBJECTIVE: This study aims to evaluate the therapeutic effects of the lateral approach combined with anteromedial approach in the treatment of terrible triad of the elbow. METHODS: Between June 2010 and January 2015, 334 patients suffering from terrible triad of the elbow, amongst whom 105 cases underwent lateral approaches combined with anteromedial approaches, 112 cases underwent lateral approaches, and 117 cases underwent anteromedial approaches were included in the study...
July 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28489627/radial-head-ingrowth-anatomic-implant-versus-smooth-stem-monoblock-implant-in-acute-terrible-triad-injury-a-prospective-comparative-study
#14
David Rodriguez-Quintana, David Beaton Comulada, Natalie Rodriguez-Quintana, Francisco Lopez-Gonzalez
OBJECTIVE: This study aimed to compare clinical outcomes and radiographic findings between patients who received 2 different implants (smooth-stemmed modular implant or an anatomic press-fit implant) on patients with acute terrible triad injuries. DESIGN: Prospective cohort. SETTING: Level II Trauma center, University hospital. PATIENTS/PARTICIPANTS: Thirty-four patients with an isolated terrible triad injury were divided into 2 study groups (n = 17 each) with different sets of radial head implants and followed for 2 years...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28314869/-operative-treatment-of-terrible-triad-injury-of-the-elbow-open-reduction-and-internal-fixation
#15
REVIEW
R Babst, C Schraner, F J P Beeres
AIM OF SURGERY: Reconstruction of the most important ligamentous and osseus structures of the elbow after terrible triad injury via the radial head to the lateral collateral ligament complex (LCL) and if necessary beginning at the coronoid process. The aim is a stable concentrically guided elbow with early functional follow-up treatment. The approach depends on the intraoperatively tested stability. INDICATIONS: Osteoligamentous terrible triad injury pattern with or without subluxation position following reduction and temporary immobilization...
April 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28102155/surgical-treatment-of-radial-head-fractures-outcomes-and-complications
#16
COMPARATIVE STUDY
Bartosz Chwedczuk, Piotr Piekarczyk, Krzysztof Kwiatkowski, Krzysztof Piątkowski
BACKGROUND: Appropriate treatment of radial head fractures remains an area of disputes and controversy. The present paper aims to assess the outcomes of surgical fixation of these injuries and identify the most common complications. MATERIAL AND METHODS: The medical records of 63 patients (25 women and 38 men) treated in 2011 -2014 were analysed retrospectively. The treatment outcomes were assessed according to the Broberg and Morrey rating system and the QuickDASH score...
October 28, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28090003/primary-hinged-external-fixation-of-terrible-triad-injuries-and-olecranon-fracture-dislocations-of-the-elbow
#17
Kensuke Sakai, Masahiro Shirahama, Naoto Shiba, Kenji Yoshida, Shiro Yoshida
This study aimed to introduce a new treatment that apples primary hinged external fixation for complex fracture-dislocations of the elbow in 12 cases. We retrospectively assessed the functional outcomes of eight patients with terrible triad injuries and three patients with an olecranon fracture-dislocation of the elbow, who were treated at our hospital using a primary hinged external fixator between June 2012 and December 2014. Ten patients underwent repair or replacement of the radial head, while three underwent repair of the olecranon...
April 13, 2017: Kurume Medical Journal
https://www.readbyqxmd.com/read/28052827/perioperative-glucocorticoid-administration-improves-elbow-motion-in-terrible-triad-injuries
#18
Mihir J Desai, Andrew P Matson, David S Ruch, Fraser J Leversedge, J Mack Aldridge, Marc J Richard
PURPOSE: Among patients who undergo surgical treatment of terrible triad elbow injuries (TTEI), we hypothesized that those who received perioperative glucocorticoid (GC) therapy would have improved postoperative pain and range of motion (ROM) and a similar complication rate compared with patients who did not receive GC therapy. METHODS: We retrospectively identified 26 patients who underwent surgical treatment of TTEI from 2009 to 2015. Thirteen patients received a single intraoperative dose of 10 mg intravenous dexamethasone followed with a 6-day oral methylprednisolone taper course (GC group), and 13 did not (control group)...
January 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27761222/comparative-analysis-of-surgical-options-for-medial-collateral-ligament-repair-in-terrible-triad-injury-of-the-elbow
#19
Taku Hatta, Shingo Nobuta, Toshitake Aizawa, Koichi Sasajima, Soichi Nakajima, Masahito Honda, Gosuke Oki, Yoshiaki Yamanaka, Eiji Itoi
The aim of our study is to evaluate the clinical and radiologic outcomes in patients with terrible triad injury, who underwent surgical treatment with or without the medial collateral ligament (MCL) repair. Fourteen patients who underwent surgery with a minimum of 12-month follow-up (mean, 17 months) were reviewed. Based on the systematic treatment protocol, radial head fracture, lateral collateral ligament, and coracoid fracture were treated. Subsequently, torn MCL was repaired in 7 patients, whereas in the remaining 7 patients, the MCL was not treated...
September 19, 2016: Orthopedic Reviews
https://www.readbyqxmd.com/read/27526068/surgical-reconstruction-of-comminuted-coronoid-fracture-in-terrible-triad-injury-of-the-elbow
#20
Hong Wu, Qiande Liao, Yong Zhu, Hua Liu
The terrible triad injury of the elbow is the combination of an elbow dislocation, a radial head fracture and a coronoid process fracture. In this study, we explored the outcome of a modified protocol for terrible triad injury of the elbow in a consecutive series of 14 patients, with a focus on reconstruction of comminuted coronoid fractures. Fourteen patients with terrible triad injuries of the elbow were retrospectively reviewed at a mean follow-up of 23 months (range, 15-30 months) and were clinically and radiographically evaluated...
December 2012: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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