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Result from surgical treatment on the terrible triad of the elbow.

de Aquino Santos A, Tonelli TA, Matsunaga FT, Matsumoto MH, Netto NA, Tamaoki MJ - Rev Bras Ortop (2015)

Bottom Line: To evaluate the results from surgical treatment of the terrible triad of the elbow, with a minimum of six months of follow-up, taking elbow function into consideration.The surgical treatment for the terrible triad of the elbow generally provided satisfactory results, when the functioning of this joint upon the return to activities was taken into consideration.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

ABSTRACT

Objective: To evaluate the results from surgical treatment of the terrible triad of the elbow, with a minimum of six months of follow-up, taking elbow function into consideration.

Methods: The analyzed aspects of 20 patients, who underwent surgical treatment of the terrible triad of the elbow, were given as follows: Dash score (Disabilities of the Arm, Shoulder and Hand), Meps (Mayo Elbow Performance Score), pain according to VAS (visual analog scale), ROM (range of motion), patient satisfaction, degree of energy of the trauma, complications and radiographs.

Results: The mean length of follow-up among the patients was 38 months. There were statistically significant relationships between the following set of parameters: trauma mechanism and patient satisfaction; radiological outcome of "heterotopic ossification" and satisfaction; functional flexion-extension ROM and satisfaction; and between type of radial head fracture and presence of a radiological outcome.

Conclusion: The surgical treatment for the terrible triad of the elbow generally provided satisfactory results, when the functioning of this joint upon the return to activities was taken into consideration.

No MeSH data available.


Related in: MedlinePlus

Front and lateral-view radiographs of the elbow demonstrating the results from the surgical treatment, with lateral ligament repair using an anchor, radial head prosthesis and osteosynthesis of the coronoid using a screw.
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fig0005: Front and lateral-view radiographs of the elbow demonstrating the results from the surgical treatment, with lateral ligament repair using an anchor, radial head prosthesis and osteosynthesis of the coronoid using a screw.

Mentions: All the patients included underwent the same surgical procedure protocol. After administration of brachial plexus block in association with general anesthesia, the patients were placed in the horizontal dorsal decubitus position and asepsis was performed using chlorhexidene and alcohol. The procedure always began through the lateral access route described by Kocher, between the extensor carpi ulnaris and the anconeus muscles. The radial head fracture was first dealt. In cases of an indication of arthroplasty, the condition of the coronoid process was verified through the same access route and the fracture was dealt with whenever possible. In all cases, the lateral ulnar collateral ligament was also repaired. In patients treated with osteosynthesis of the radial head and in cases of persistence of elbow instability, an additional medial access route was created in order to perform osteosynthesis of the coronoid or repair of the anterior capsule and, when necessary, repair or reconstruction of the medial collateral ligament. After repairing all these structures, if there was any remaining instability, a dynamic external fixator was used (Fig. 1).


Result from surgical treatment on the terrible triad of the elbow.

de Aquino Santos A, Tonelli TA, Matsunaga FT, Matsumoto MH, Netto NA, Tamaoki MJ - Rev Bras Ortop (2015)

Front and lateral-view radiographs of the elbow demonstrating the results from the surgical treatment, with lateral ligament repair using an anchor, radial head prosthesis and osteosynthesis of the coronoid using a screw.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563041&req=5

fig0005: Front and lateral-view radiographs of the elbow demonstrating the results from the surgical treatment, with lateral ligament repair using an anchor, radial head prosthesis and osteosynthesis of the coronoid using a screw.
Mentions: All the patients included underwent the same surgical procedure protocol. After administration of brachial plexus block in association with general anesthesia, the patients were placed in the horizontal dorsal decubitus position and asepsis was performed using chlorhexidene and alcohol. The procedure always began through the lateral access route described by Kocher, between the extensor carpi ulnaris and the anconeus muscles. The radial head fracture was first dealt. In cases of an indication of arthroplasty, the condition of the coronoid process was verified through the same access route and the fracture was dealt with whenever possible. In all cases, the lateral ulnar collateral ligament was also repaired. In patients treated with osteosynthesis of the radial head and in cases of persistence of elbow instability, an additional medial access route was created in order to perform osteosynthesis of the coronoid or repair of the anterior capsule and, when necessary, repair or reconstruction of the medial collateral ligament. After repairing all these structures, if there was any remaining instability, a dynamic external fixator was used (Fig. 1).

Bottom Line: To evaluate the results from surgical treatment of the terrible triad of the elbow, with a minimum of six months of follow-up, taking elbow function into consideration.The surgical treatment for the terrible triad of the elbow generally provided satisfactory results, when the functioning of this joint upon the return to activities was taken into consideration.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

ABSTRACT

Objective: To evaluate the results from surgical treatment of the terrible triad of the elbow, with a minimum of six months of follow-up, taking elbow function into consideration.

Methods: The analyzed aspects of 20 patients, who underwent surgical treatment of the terrible triad of the elbow, were given as follows: Dash score (Disabilities of the Arm, Shoulder and Hand), Meps (Mayo Elbow Performance Score), pain according to VAS (visual analog scale), ROM (range of motion), patient satisfaction, degree of energy of the trauma, complications and radiographs.

Results: The mean length of follow-up among the patients was 38 months. There were statistically significant relationships between the following set of parameters: trauma mechanism and patient satisfaction; radiological outcome of "heterotopic ossification" and satisfaction; functional flexion-extension ROM and satisfaction; and between type of radial head fracture and presence of a radiological outcome.

Conclusion: The surgical treatment for the terrible triad of the elbow generally provided satisfactory results, when the functioning of this joint upon the return to activities was taken into consideration.

No MeSH data available.


Related in: MedlinePlus