TERRIBLE TRIAD OF THE ELBOW

Course overview

AS A VOLATILE FORM OF FRACTURE-DISLOCATION CONSISTING OF ELBOW DISLOCATION WITH CONCOMITANT RADIAL HEAD OR NECK AND CORONOID PROCESS FRACTURES, THE “TERRIBLE TRIAD” OF THE ELBOW IS A COMPLEX INJURY THAT, IF NOT TREATED APPROPRIATELY, CAN PORTEND PAIN, STIFFNESS, AND POST-TRAUMATIC ARTHRITIS. GIVEN THE ELBOW IS THE SECOND MOST COMMONLY DISLOCATED JOINT IN THE UPPER EXTREMITY, WITH NEARLY 20% OF DISLOCATIONS ASSOCIATED WITH A FRACTURE, THE PREVENTION OF COMPLICATIONS MENTIONED ABOVE REQUIRES AN UNDERSTANDING OF THE DISLOCATING FORCES THAT COMBINE FOREARM ROTATION AND VALGUS DEFORMITY UNTO AN EXTENDED ELBOW WHILE THE FOREARM EXPERIENCES AXIAL COMPRESSION. PROGRESSION OF PATHOLOGIC, BIOMECHANICAL, AND CLINICAL KNOWLEDGE ACROSS THE PAST FEW DECADES HAS PERMITTED ADVANCEMENTS IN SURGICAL APPROACHES TO RESTORE STABILITY, PROVIDE ANATOMICAL REPAIR, ENABLE EARLY MOBILIZATION, AND PREVENT THE ONSET OF STIFFNESS. THIS ACTIVITY AIMS TO PROVIDE READERS WITH THE TOOLS NECESSARY TO APPROPRIATELY EXAMINE AND EVALUATE, DIAGNOSE, AND TREAT TERRIBLE TRIAD INJURIES OPERATIVELY, WITH THE CARE TO CONTINUE CLOSE POSTOPERATIVE MONITORING WHILE FOLLOWING THERAPY PROTOCOLS.