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Results of treatment of terrible triad injury of the elbow

Background/aim A complex elbow dislocation with associated radial head and coronoid process fractures was named the terrible triad by Hotchkiss because of historically poor outcomes. This study aimed at assessing the results and functional outcome of treatment of terrible triad injuries of the elbow. Patients and methods Between 2010 and early 2013, 11 patients suffering from terrible triad injuries of the elbow were treated at Assiut University Hospitals; eight were male individuals and three were female individuals with the mean age of 43 years (range: 26–70 years). The right elbow was injured in five, and the left was injured in six patients. The radial head was replaced by a prosthesis in five and treated by internal fixation in five patients, whereas conservative treatment was decided only in one patient; the coronoid process was fixed by screws in four, whereas four were treated by suturing of the anterior capsule and were treated conservatively. Results The mean follow-up was 13.3 months (range: 6–30 months) According to the Mayo Elbow Performance Score, three patients had excellent outcome, seven had good outcome, whereas only one had fair outcome. Conclusion Prompt surgical attention with a systematic approach to restore anatomy and provide sufficient stability to allow early motion are the key factors for a successful outcome.