Dislocations of the Elbow and Intraarticular Fractures

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

“…First, removal of the radial head for planned arthroplasty allows for better visualization of the coronoid fracture fragment. The importance of adequate coronoid fixation in terrible triad injuries has been documented previously [5,7,8,11,21]. Improved visualization through the existing lateral incision may potentially allow for better reduction and fixation, regardless of fixation technique.…”

“…Several recent studies [4,5,19,24] that applied algorithmic approaches to managing each individual injury in the triad have demonstrated more promising results than historical studies [11,20,21] that previously documented high rates of persistent pain, posttraumatic arthrosis, contractures, instability, and functional limitations after treatment. These surgical protocols recommend various fixation techniques for each of the three critical aspects of terrible triad pathoanatomy.…”

Coronoid Fractures of the Elbow

“…16 Major traumas such as motor vehicle accidents can also cause these injuries. 15,18 The most common cause of an elbow dislocation is a fall on the elbow or outstretched hand from standing height 4,14,19 or higher. 4,15,[18][19][20][21][22][23] The specific mechanisms of coronoid fracture (and elbow dislocation) are varied and can involve twisting and flexion, as well as hyperextension.…”

“…15,18 The most common cause of an elbow dislocation is a fall on the elbow or outstretched hand from standing height 4,14,19 or higher. 4,15,[18][19][20][21][22][23] The specific mechanisms of coronoid fracture (and elbow dislocation) are varied and can involve twisting and flexion, as well as hyperextension. 5,10,22,24,25 When the elbow is axially loaded in extension, force is concentrated on the articular surface of the coronoid process.…”

“…1,21,26 However, until recently there has not been a great deal of evidence either describing instability associated with Morrey type I coronoid fractures or supporting the efficacy of their repair. 20 Josefsson 19 reported on 4 patients who experienced recurrent instability following an initial dislocation. All had an associated small fragment fracture of coronoid that was not Possible explanations include recent anatomic evidence that noted the capsule usually attaches very close to the tip of the coronoid process.…”