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Complex Elbow Dislocations and the "Terrible Triad" Injury
Alistair D R Jones1, Robert W Jordan2
1Department of Trauma and Orthopaedics, Worcestershire Royal Hospital, Charles Hastings Way, WR5, Worcester, 1DD, UK.
The Open Orthopaedics Journal
|January 2, 2018
Summary
Complex elbow dislocations, often with fractures, require careful management. Treatment varies by injury type, with surgical options for severe cases carrying high complication risks.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Biomechanics
Background:
- Elbow dislocations are common in adults, with fractures occurring in up to 20%.
- Injuries are classified by mechanism and affected structures.
Purpose of the Study:
- To review current evidence and author experience in managing complex elbow dislocations and associated fractures.
- To highlight treatment considerations and outcomes for various injury patterns.
Main Methods:
- Literature search of existing evidence.
- Synthesis of personal experiences in managing elbow injuries.
Main Results:
- Initial management involves closed reduction and splinting, followed by evaluation.
- Radial head fractures require stability restoration; terrible triad injuries often need surgery.
- Coronoid fragment size impacts stability; post-reduction CT scans are crucial. Anterior dislocation with olecranon fracture needs extensor mechanism repair.
Conclusions:
- Complex elbow dislocations pose a significant risk of long-term disability.
- Limited high-level evidence exists, with most data from case series.