The Clinical Treatment With The Poster-lateral Approach Combined With Anterior-medial Approach To Cure The Terrible Triads In The Elbow

Objective To discuss the efficacy of the surgical treatment for the terrible triads in the elbow by poster-lateral approach combined with anterior-medial approach.Methods 18 cases selected From October 2014 to October 2016 in Ningxia Medical University General Hospital as the research object,all patients including 14 males and 4 females received the surgical treatment of with the terrible triads in the elbow by poster-lateral combined with anterior-medical approach.The average age was 40.75(ranged from 22 to 56).Left in 5 cases,Right in 13 cases.To the radius head fracture,according to the improved Mason classification by Hotchkiss : all cases classified in type ?;To the ulna coracoid process fractures,according to the Regan-Morrey classification: type? in 11 cases,type? in 4 cases,type? in 3 cases.The average time from the injury to surgery was 6days(ranged from 1day to 17 days).18 cases with the terrible triads in the elbow were evaluated by the bone healing,soft tissue repairing,postoperative complication,elbow score and elbow joint function improvement.Results The study including 18 cases,all the patients were follow-up from 6 to 30 months,average follow up duration was 12.3 months.Preoperative ROM(range of motion): flexion and extension(63.5°±7.2°),pronation and supination(73.5°±8.4°).All cases' X-ray bone were healed,the revenge time of healing was 10.4 weeks(range from 8 weeks to 13weeks).No postoperative infection and elbow joint instability occurred.The last follow-up ROM: flexion and extension(115.25°±9.6°),pronation and supination(124.625°±12.03°);The ROM of the normal side:flexion and extension(119±11.67°),pronation and supination(128.25±10.29°);The MEPS score: excellent in 10 cases,good in 6 cases,fair in 2 cases,no bad.It shows significant differences(P < 0.05)when compared with the preoperative data.It shows no significant differences(P > 0.05)when compared with the normal data.Conclusion The poster-lateral approach combined with anterior-medial approach for the treatment of the terrible triads in the elbow can restore bone and soft tissue,heal the bone well,be significantly improved the stability of elbow joint,have a great extent improve ROM,have Elbow early functional exercise painless,meet the needs of daily life,it's efficacy reliable and satisfactory.This approach is safe and convenient,revealing clear,accurate reduction can be used directly,and can be stable fixing;have less chance to damage blood vessels and nerves,reduce the dissection of soft tissue,less preoperative complication and have a good recovery.Is the effective surgical method and approach for clinical treatment for the terrible triads in the elbow associated with of the clinical treatment of the disease has guiding significance.