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

Abstract

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.

Variant of the terrible triad of the elbow, a CASE report with a review of the literature

“…In elbow trauma, the greater the number of elements and possibly columns affected, the more the stability of the elbow will be compromised [ 8 ]. Each of these columns is necessary to preserve stability and the arc of mobility [ 9 ]. Instability leads to chronic decentralization of the joint.…”

Management of Ipsilateral Terrible Triad Injury of Elbow and Concomitant Proximal Humerus Fracture: A Case Report and Literature Review

“…The phrase “terrible triad” implies a devastating set of injuries that usually include fractures to the radial head, elbow dislocation, and coronoid fracture. When it comes to functional outcomes and management, this intricate damage pattern poses serious issues [ 1 , 2 ]. It is quite uncommon for there to be a simultaneous proximal humerus fracture added to this trio, which further complicates the clinical presentation and treatment choices.…”