Terrible Triad of the Elbow: Functional Results of Surgical Treatment

Objective To evaluate the functional and radiographic results of patients who underwent surgical treatment for terrible triad-type elbow injuries (TTE). Methods We retrospectively evaluated 20 patients, including one case with bilateral injuries (total of 21 elbows) that were surgically treated from January 2004 to July 2014. We evaluated the functional results of treatment by measuring the restored range of motion (ROM) of the elbow, using the DASH (Disabilities of the Arm, Shoulder and Hand) and MEPS (Mayo Elbow Performance Score) scores. Complications and the development of osteoarthritis and heterotopic ossification (HO) were also evaluated. Results Eight elbows (38%) required additional surgical treatment; HO was observed in eight elbows (38%) and severe osteoarthritis (Broberg-Morrey type IV) was seen in only one case (4%). Nevertheless, we obtained good functional results, 14.27 on the DASH and 84 on the MEPS. The average ROM for flexion-extension was 101° (20-140°) and for pronation-supination was 112.85° (0-180°). Conclusion When TTE injuries are treated systematically, even despite variations in these injuries, functional ROM and scores ranging from good to excellent can be obtained. Level of Evidence IV, Case Series.