Management of a 38-Year-Old Man With Complex Elbow Fracture-Dislocations and Triceps Tendon Avulsion: A Case Report

Terrible triad injuries of the elbow, which combine posterior dislocation, radial head fracture, and coronoid process fracture, present significant management challenges due to the high potential for instability and stiffness. These injuries require prompt diagnosis and a carefully planned surgical approach to restore joint stability and function. This report describes a complex case involving a 38-year-old male who sustained a terrible triad injury with an uncommon complication of triceps tendon avulsion after a motor vehicle accident. The injury consisted of a comminuted radial head fracture, a coronoid process fracture, a posterior elbow dislocation, and complete avulsion of the triceps tendon from the olecranon. The patient underwent surgical management, including excision of the comminuted radial head without arthroplasty, anterior capsular repair, triceps tendon reattachment, and dual-column ligament repair for comprehensive stabilization. Postoperative immobilization and structured physiotherapy led to a successful recovery. At 6 months, the patient demonstrated a functional range of motion, with no residual pain or instability, enabling him to resume daily activities. This case highlights the importance of early surgical intervention and comprehensive stabilization in managing complex elbow injuries. It also underscores the viability of radial head excision as an alternative to arthroplasty in selected cases. A comparison with previously reported cases demonstrates the need for individualized treatment strategies to optimize patient outcomes. This case highlights the importance of early surgical intervention and comprehensive stabilization in managing complex elbow injuries, such as the terrible triad with triceps tendon avulsion. The successful outcome in this case, achieved without radial head arthroplasty, underscores that radial head excision can be a viable option under certain conditions, though further investigation is needed to evaluate its long-term effectiveness.