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J Musculoskelet Trauma : Journal of Musculoskeletal Trauma

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Hyun Sik Ahn 1 Article
Posterior Dislocation of Elbow Joint with Fracture of Radial Head and Coronoid Process (Terrible triad of Elbow Fracture and Dislocation): case report
Eui Hwan Ahn, Sung Tae Lee, Hyun Sik Ahn
J Korean Soc Fract 2000;13(4):1011-1015.   Published online October 31, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.4.1011
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Dislocation of the elbow with fracture of the radial head and the coronoid process is a complex injury that includes severe damage to both soft tissue and bone. The above injury is named as 'terrible triad of elbow fracture and dislocation'. This injury is very rare and difficult to treat and this combined lesion has been reported to have a worse prognosis than either of the single injury. The complications of ectopic ossification, recurrent dislocation, and loss of motion are recognized as a source of considerable concern to the treating orthopaedic surgeon. Many authors emphasized the importance of fixation of coronoid process. The proper management of radial head fracture is controversial. Whatever method used, the elbow must be stable enough to permit early motion. We treated 2 patients who sustained posterior dislocation of elbow with fracture of radial head and coronoid process. First case was treated by closed reduction for dislocation of elbow immediately. After 2 days, radial head was excised and coronoid process was fixed with pulled-out technique. Second case was treated by closed reduction for dislocation of elbow immediately. After 3 days, radial head was treated with open reduction and internal fixation with K-wire and teared anular ligament was repaired. Clinical result of both cases was good
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