The Analysis Of The Factors That May Affect The Terrible Triad Of The Elbow

Objectives: To provide reference for the clinical treatment and prognosis about theterrible triad of the elbow by analyzing these related factors which may affect thesurgical result.Method: The clinical data of6cases of the terrible triad of the elbow in our hospitalfrom January,1th,2003to December,30th,2013were retrospectively analyzed.Between8hours and7days (average4.5days), resetting and Fixating the radial headfracture and ulna coronoid fracture by lateral approach on the elbow. At the same time,repair the joint capsule and medial and lateral ligaments. Plaster fixation was requiredunder elbows buckled90°and forearm in a neutral position. On the next day, thefunctional training was required for both shoulder joint and wrist joint. After oneweek, the passive functional trading was needed. And then after3weeks, to have theinitiative functional training.Based on clinical data and follow-up result from these6patience, to analyze factors,which may affect the surgical result。Results:6cases were all followed for average12.4month. There were no incisioninfection and necrosis, no urinary system infection and lungs infection etccomplication. The X-ray result in review shows that the fracture position was goodand all healed well after average3month. Besides, the elbow joint was stable in thebody check. From the Mayo elbow function score standard, the follow up result are:Excellent2, good3and acceptable1， the rate of excellent and good is83.33％。Conclusions: Surgery was taken as the mainly treatment for terrible triad of theelbow with good result. This group was all operated by Kocher lateral on the elbow between8hours and7days after injured. First is resetting radial head by screw orreplace prosthetic, and suturing or removing coronoid process to repair lateralstructure. Then fixed by plaster. In order to achieve good result, teaching patient to dofunctional practice. The factors which affect the treatment for terrible triad of theelbow were related to type of fracture, treatment, operative approach, timing ofsurgery and braking time. More cognition should be taken in clinical treatment.Surgery should be taken as early as possible. The next action should be recovering thestructure of bony anatomy of elbow, and repairing the joint capsule and medial andlateral ligaments. Then to recover the stability of elbow. After the surgery, functionaltraining need to be taken earlier to avoid the anchylosis of the elbow and recover thejoint function with a good result.