The Terrible Triad of the Elbow Accompanied by Capitellum and Humerus Shaft Fracture: A Rare Case Report


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Cengiz T., Aydin S., Erdogan F., Mraja H. M., Coşkun H. S.

CUREUS JOURNAL OF MEDICAL SCIENCE, cilt.14, sa.8, 2022 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 14 Sayı: 8
  • Basım Tarihi: 2022
  • Doi Numarası: 10.7759/cureus.27658
  • Dergi Adı: CUREUS JOURNAL OF MEDICAL SCIENCE
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI)
  • Anahtar Kelimeler: humerus shaft, fluoroscopy, capitellum, elbow dislocation, elbow fractures, terrible triad
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

The terrible triad of the elbow consists of radial head fracture and coronoid process fracture in addition to posterior dislocation of the elbow. It indicates high-risk complications such as instability, malunion, nonunion, and proximal radioulnar synostosis. We describe a rare case that was admitted to the emergency service with a terrible triad of the elbow with additional capitellum fracture, lateral collateral ligament (LCL) injury, and ipsilateral humeral shaft fracture. We treated the patient urgently by performing osteosynthesis of the humeral shaft fracture, radial head fracture, coronoid fracture, capitellum fractures, and repair of the LCL rupture. The terrible triad of the elbow also can be accompanied by adjacent column fractures, including the humeral shaft. In such complex cases, preoperative planning should be done well, and the entire anatomy should be demonstrated with additional imaging. Optimal treatment of all the fractured bones and ligaments is critical for early rehabilitation. The main aim of surgery is to acquire desired results by starting an early rehabilitation, including joint movement.