Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the Elbow
Purpose. To report outcomes in 6 patients with the terrible triad of the elbow treated with our modified protocol. Methods. 6 men aged 26 to 54 years underwent surgery for the terrible triad of the elbow by a single surgeon. All the patients had a displaced comminuted fracture of the radius, posteri...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2009-04-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/230949900901700108 |
| _version_ | 1818192777798746112 |
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| author | V Pai V Pai |
| author_facet | V Pai V Pai |
| author_sort | V Pai |
| collection | DOAJ |
| description | Purpose. To report outcomes in 6 patients with the terrible triad of the elbow treated with our modified protocol. Methods. 6 men aged 26 to 54 years underwent surgery for the terrible triad of the elbow by a single surgeon. All the patients had a displaced comminuted fracture of the radius, posterior dislocation of the elbow, and Morrey type-I fracture of the coronoid. They all underwent replacement of the radial head and repair of the lateral collateral ligament to the isometric part of the lateral condyle using suture anchors. Five had an additional capsular fixation to the anterior coronoid using suture anchors; in patient 6 the coronoid was not repaired because it was stable. Functional outcomes were evaluated using the Hospital for Special Surgery (HSS) elbow assessment score. Bone union, implant loosening, heterotopic ossification, and degenerative changes were assessed using anteroposterior and lateral radiographs. Results. After a mean follow-up of 2.2 (range, 1–3) years, the mean arc of flexion-extension was 116 degrees and the mean flexion contracture was 15 degrees. All patients maintained a concentric reduction of both the ulnotrochlear and the radiocapitellar articulation, with isometric fixation of the lateral collateral ligament. No patient had dislocation of the radial-head prosthesis. All had good-to-excellent HSS elbow scores, and none required re-operation. Patient 2 had neuropraxia of the radial nerve, which recovered within 3 months. Patient 4 had a range of movement of only 20 to 100 degrees, but was satisfied with the outcome. Conclusion. Repair of the articular capsule using suture anchors in addition to replacement of the radial head and repair of the lateral collateral ligament achieves favourable outcome in patients with the terible triad of the elbow. |
| first_indexed | 2024-12-12T00:35:54Z |
| format | Article |
| id | doaj.art-ce6cf76d018a4033ba9515a6b8b00fe9 |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-12-12T00:35:54Z |
| publishDate | 2009-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-ce6cf76d018a4033ba9515a6b8b00fe92022-12-22T00:44:22ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902009-04-011710.1177/230949900901700108Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the ElbowV Pai0V Pai1 Gisborne Hospital, New Zealand Alfred hospital, Melbourne, AustraliaPurpose. To report outcomes in 6 patients with the terrible triad of the elbow treated with our modified protocol. Methods. 6 men aged 26 to 54 years underwent surgery for the terrible triad of the elbow by a single surgeon. All the patients had a displaced comminuted fracture of the radius, posterior dislocation of the elbow, and Morrey type-I fracture of the coronoid. They all underwent replacement of the radial head and repair of the lateral collateral ligament to the isometric part of the lateral condyle using suture anchors. Five had an additional capsular fixation to the anterior coronoid using suture anchors; in patient 6 the coronoid was not repaired because it was stable. Functional outcomes were evaluated using the Hospital for Special Surgery (HSS) elbow assessment score. Bone union, implant loosening, heterotopic ossification, and degenerative changes were assessed using anteroposterior and lateral radiographs. Results. After a mean follow-up of 2.2 (range, 1–3) years, the mean arc of flexion-extension was 116 degrees and the mean flexion contracture was 15 degrees. All patients maintained a concentric reduction of both the ulnotrochlear and the radiocapitellar articulation, with isometric fixation of the lateral collateral ligament. No patient had dislocation of the radial-head prosthesis. All had good-to-excellent HSS elbow scores, and none required re-operation. Patient 2 had neuropraxia of the radial nerve, which recovered within 3 months. Patient 4 had a range of movement of only 20 to 100 degrees, but was satisfied with the outcome. Conclusion. Repair of the articular capsule using suture anchors in addition to replacement of the radial head and repair of the lateral collateral ligament achieves favourable outcome in patients with the terible triad of the elbow.https://doi.org/10.1177/230949900901700108 |
| spellingShingle | V Pai V Pai Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the Elbow Journal of Orthopaedic Surgery |
| title | Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the Elbow |
| title_full | Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the Elbow |
| title_fullStr | Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the Elbow |
| title_full_unstemmed | Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the Elbow |
| title_short | Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the Elbow |
| title_sort | use of suture anchors for coronoid fractures in the terrible triad of the elbow |
| url | https://doi.org/10.1177/230949900901700108 |
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