Technical Trick: Coronoid Fracture "Lasso" Repair Using Arthroscopic Instrumentation in Terrible Triad Injuries With...

Area of Science:

• Orthopedic Surgery
• Arthroscopy
• Elbow Trauma Management

Background:

• Terrible triad elbow injuries involve complex dislocations requiring surgical intervention.
• Traditional open repairs can be invasive, potentially leading to complications.
• Arthroscopic techniques offer minimally invasive alternatives for complex joint injuries.

Purpose of the Study:

• To describe a novel, single-stage, laterally-based arthroscopic approach for treating terrible triad elbow injuries.
• To present a "lasso" fixation technique for coronoid fractures and anterior capsular injuries.
• To highlight the use of specialized arthroscopic instruments for improved precision and ease of repair.

Main Methods:

• A laterally-based arthroscopic approach was utilized for single-stage operative repair.
• Arthroscopic instrument-assisted reduction was employed for coronoid fractures.
• A "lasso" fixation technique using an arthroscopic suture lasso, adjustable drill guides, cannulated guide-pins with nitinol shuttling wires, and a suspensory cortical button was implemented.
• This technique was applied in cases where radial head repair was deemed appropriate over arthroplasty.

Main Results:

• The described technique allows for precise and facile "lasso" fixation of coronoid fractures.
• Anterior capsular injuries associated with intact radial heads were effectively addressed.
• The method facilitates single-stage repair through a minimally invasive arthroscopic approach.

Conclusions:

• A single-stage operative repair of terrible triad injuries is feasible using a laterally-based arthroscopic approach.
• Arthroscopic instrument-assisted reduction and "lasso" fixation provide a precise and facile technique for coronoid fractures and capsular injuries.
• This technical trick is suitable for terrible triad injuries where radial head repair is indicated over arthroplasty.