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Pediatric terrible triad elbow fracture dislocations: report of 2 cases

Zoe H Dailiana1, Loukia K Papatheodorou, Sotirios G Michalitsis

  • 1Department of Orthopaedic Surgery and Musculoskeletal Trauma, Faculty of Medicine, University of Thessaly, Larissa, Greece. dailiana@med.uth.gr

The Journal of Hand Surgery
|July 30, 2013
PubMed

Insights

Pediatric elbow injuries, known as the terrible triad, are rare and unpredictable. This study reports two pediatric cases with good early outcomes, though one showed avascular necrosis of the radius.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Traumatology

Background:

  • The terrible triad injury, an elbow dislocation with radial head and coronoid process fractures, presents unpredictable outcomes in adults and is exceptionally rare in children.
  • This complex elbow injury requires careful management due to its potential for long-term morbidity.

Observation:

  • This report details two pediatric cases of the terrible triad injury.
  • One case also involved an olecranon fracture, further complicating the injury pattern.

Findings:

  • Both pediatric patients demonstrated favorable early clinical outcomes following treatment for their terrible triad injuries.
  • Radiographic evaluation in one patient revealed the development of avascular necrosis in the proximal radius, indicating a potential long-term complication.

Implications:

  • These cases highlight that while early outcomes can be positive, vigilant radiographic monitoring is crucial in pediatric terrible triad injuries.
  • The findings suggest a need for further research into the long-term prognosis and management strategies for this rare pediatric condition.

Keywords:
Childrencoronoid process fractureelbow terrible triadolecranon fractureradial head fracture

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