Functional evaluation of patients with surgically treated terrible triad of the elbow

Brigato, Rafael Mulatti; Mouraria, Guilherme Grisi; Kikuta, Fernando Kenji; Coelho, Sérgio de Paula; Cruz, Márcio Alves; Filho, Américo Zoppi

doi:10.1590/1413-78522015230301008

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…6,17,20 Muñoz-Mahamud et al evaluated 17 patients with TTE with a mean age of 56 years, finding chronic pain and discomfort in 31.2% of patients at a mean follow-up of 8.6 years. 35 Studies in adults have shown "fair" and "good" results on the basis of a variety of functional outcome scoring systems, with a reduced final ROM a common factor, 7,14 and complication rates ranging from 0% to 54%. 14 Comparatively, the majority of this pediatric cohort received scores of "good" or "excellent" according to the Flynn criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Posterolateral valgus stress on an extended elbow is believed to be a common mechanism for TTE. 7 Lateral collateral ligament (LCL) tears are thought to be universally present, whereas the medial collateral ligament (MCL) is the last structure to fail. Therefore, TTE is a circumferential elbow injury, combining elbow dislocation with a medial (coronoid and MCL) and lateral (radial head and LCL) injury.…”

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confidence: 99%

“…TTE is often caused by a high-energy fall on an outstretched hand. Posterolateral valgus stress on an extended elbow is believed to be a common mechanism for TTE 7. Lateral collateral ligament (LCL) tears are thought to be universally present, whereas the medial collateral ligament (MCL) is the last structure to fail.…”

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confidence: 99%

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Complex Fracture-Dislocations of the Elbow in the Pediatric Population

Magee

Baghdadi

Gohel

et al. 2021

Journal of Pediatric Orthopaedics

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Background: Complex fracture-dislocations of the elbow, including terrible triad of the elbow, are serious injuries with guarded outcomes in adults. Although described extensively in adults, little is known about similar complex fracturedislocations of the elbow in the pediatric population. The purpose of this study was to describe patterns of elbow dislocations with associated fractures in children and report the outcomes of these injuries. Methods: This was a retrospective review of patients who presented to a level I trauma center from 2007 to 2019 with an elbow dislocation and at least 2 associated fractures. Demographic data, fracture locations, and treatment modality were recorded. Operative reports and radiographs were reviewed to determine clinical outcomes and complications. Results: A total of 26 patients (mean age, 9.8 y) were identified. The majority of patients sustained an elbow dislocation and a medial epicondyle fracture (n = 16). The most common third fractures involved the lateral condyle (n = 8) or radial neck (n = 7). At mean 6.03 ± 3.11 months follow-up, 3 patients lacked ≥ 10 degrees of extension, and 2 patients lacked ≥ 15 degrees of flexion. Most patients had a Flynn score of "excellent" (n = 20, 76.9%) or "good" (n = 2, 7.7%). One patient with significant residual stiffness ( > 30 degrees flexion contracture) eventually underwent open contracture release. Conclusions: The most common complex elbow fracturedislocation pattern in this series was an elbow dislocation with fracture of the medial epicondyle and lateral condyle or radial neck. In contrast to adult terrible triad injuries, most patients had a favorable clinical outcome, with nearly 80% excellent results and a low rate of complications. Level of Evidence: Therapeutic Level IV-case series.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Complex Fracture-Dislocations of the Elbow in the Pediatric Population

Magee

Baghdadi

Gohel

et al. 2021

Journal of Pediatric Orthopaedics

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“…Patients were assessed regarding range of motion with a goniometer, which measured the degrees of flexion-extension and pronosupination, and presence of pain, assessed by the visual analog scale (VAS); the Andrews-Carson 8 and the Mayo Elbow Performance Score (MEPS) scores were applied 9 …”

Section: Methodsmentioning

confidence: 99%

Acute distal biceps ruptures: single incision repair by use of suture anchors

Maciel

Costa

Figueiredo

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveClinical and functional assessment of the surgical treatment for acute injury of the distal insertion of the biceps brachial performed with a surgical technique using a single incision in proximal forearm and fixation with suture anchors in the radial tuberosity.MethodsThis study reviewed the medical records of patients who underwent surgical treatment of distal biceps injury during the period between January 2008 and July 2014. In a mean follow-up of 12 months, 22 patients with complete and acute injury, diagnosed through physical examination and imaging studies, were functionally assessed in the postoperative period regarding the range of motion (degrees of flexion-extension and pronation–supination), the presence of pain (VAS), the Andrews Carson-score, and the Mayo Elbow Performance Score (MEPS).ResultsDuring the postoperative follow-up assessment, no patient reported pain by VAS scale; all were satisfied with the esthetic appearance of the surgery. The range of articular movement remained unchanged at 95.4% of patients, with the loss of 8° of supination in one patient. No changes in muscle strength were observed. The results of the Andrews-Carson score were good in 4.6% and excellent in 95.4% of cases; the MEPS presented 100% of excellent results. The rate of complications was 27.2%, similar to the literature.ConclusionSurgical repair of acute injury of the distal biceps trough a single incision in the proximal forearm and fixation with two suture anchors in the radial tuberosity is an effective and safe therapeutic option, allowing early motion and good functional results.

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Comparison of different treatment approaches for coronoid process fracture in terrible triad injury: a multicenter, randomized controlled study

Wang

Rui

et al. 2023

International Orthopaedics (SICOT)

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Functional evaluation of patients with surgically treated terrible triad of the elbow

Cited by 9 publications

References 10 publications

Complex Fracture-Dislocations of the Elbow in the Pediatric Population

Complex Fracture-Dislocations of the Elbow in the Pediatric Population

Acute distal biceps ruptures: single incision repair by use of suture anchors

Comparison of different treatment approaches for coronoid process fracture in terrible triad injury: a multicenter, randomized controlled study

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