He has published over 230 papers, chapters and reviews primarily in the field of chondrocyte biology. Dailiana ZH, Papatheodorou LK, Michalitsis SG, Varitimidis SE. CT scan of the elbow should be performed to assess the suitability of radial and coronoid fractures for repair or replacement [29] (Figs. Br J Surg 1954; 42(172): 123-32. Non-operative treatment comprises a period of immobilization to allow fracture healing before joint mobilization with physiotherapy. Good outcomes were achieved with LCL repair only for Subgroup 1 fractures, and AMCF fixation and LCL repair for subgroup II and III Injuries. The stabilizers of the elbow are disrupted from lateral to medial as the forearm supinates and is loaded [23]. Classification and treatment of coronoid process fractures. J Hand Surg Am 2010; 35(3): 464-7. The articles are among the best and cover most scientific areas. This highlights the need of the surgeon to thoroughly assess the patient with routine examination of structures around the elbow that are not usually associated with complex dislocation. USA.gov. [ Links ] 3 Morrey BF, Chao EY, Hui FC. If reconstruction of the olecranon is not possible because of severe comminution, osteoporotic bone, concomitant injuries or patient factors then delayed fragment excision and triceps advancement may be used to salvage the extensor mechanism [59]. Treatment aims to restore the articular surface and extension mechanism of the elbow. Regan WD, Korinek SL, Morrey BF, An KN. J Hand Surg Am 2007; 32(8): 1200-9. Recent studies [31, 33] have shown that reconstruction of the MCL is unnecessary in patients with a stable joint after repair of other structures, and that coronoid fractures do not need to be fixed if there is stability in the range of motion after repair of lateral structures. Josefsson PO, Gentz CF, Johnell O, Wendeberg B. Surgical versus non-surgical treatment of ligamentous injuries following dislocation of the elbow joint. If fractures are partial articular, they involve the anteromedial facet of the radial head most often, followed by the anterolateral facet [15].  |  Brink PR, Windolf M, de Boer P, Brianza S, Braunstein V, Schwieger K. Tension band wiring of the olecranon: Is it really a dynamic principle of osteosynthesis? NIH Clin Orthop Relat Res 2014; 472(7): 2084-91. The aim of surgery is to stabilise the joint by repairing either the LCL, coronoid fragment or both structures. The goals of this article are to review the pertinent anatomy, mechanism of injury, classification and imaging of terrible triad injuries of the elbow with brief descriptions of treatment, and complications of this complex injury. -, J Shoulder Elbow Surg. The combination of elbow dislocation with both radial head and coronoid process fracture is notoriously challenging to treat and, as such, has been termed “terrible triad” injury of the elbow (TTIE) .This type of elbow injury is typically due to low or high energy falls onto an outstretched hand, which results in valgus and axial compression of the supinated forearm . J Bone Joint Surg Am 2004; 86-A(6): 1122-30. AIM OF SURGERY: Reconstruction of the most important ligamentous and osseus structures of the elbow after terrible triad injury via the radial head to the lateral collateral ligament complex (LCL) and if necessary beginning at the coronoid process. 2009;17(3):137-51. Varus posteromedial rotational instability fracture-dislocations have only recently been described as having the potential to cause severe long-term problems. Surgical treatment of terrible triad injuries carries a high complication rate with an average of 22% reoperation rate [39]. Between 5 and 20% are associated with a fracture [1, 2] and this combination may complicate recovery. J Bone Joint Surg Am 2007; 89(Suppl. The elbow is the second most commonly dislocated joint in adults. The tension band principle relies on a solid buttress on the articular surface of the olecranon, and is not suitable in severe comminution. Surgical technique. Some of the most common injury classification systems cited in … J Orthop Trauma 2008; 22(5): 325-31. Definition and Injury Mechanism of the Terrible Triad • The terrible triad of the elbow is defined as the combination of • fractures of the radial head and • ulnar coronoid process • dislocation of the elbow joint (Fig. Better long term results are seen in displaced or comminuted type III fractures treated with radial head replacement rather than excision when there is instability as seen with fracture dislocations [21, 22]. Hyperextension can also cause anterior dislocation, as the ulna is levered past the anterior humeral edge and the olecranon fragment pulled posteriorly by triceps as the humerus is driven through the olecranon. Complex elbow dislocations encompass a large range of injuries from dislocations associated with undisplaced radial head fractures to significant bony injuries causing chronic instability. If an anteromedial coronoid fracture is seen with olecranon fracture and history of dislocation then the mechanism is more likely one causing varus posteromedial rotational instability, and should be treated as such with coronoid and/ or LCL repair with additional olecranon fixation. C.A. Dynamic stability encompasses the congruity of the articulation when the muscles crossing the elbow joint contract to enable movement [7]. Fracture of the anteromedial facet of the coronoid process. 2014; 37(12): 831-7. de Haan J, Schep N, Tuinebreijer W, den Hartog D. Complex and unstable simple elbow dislocations: A review and quantitative analysis of individual patient data. Prolonged immobilization in plaster for longer than 4 weeks is detrimental [18]. An extensive search of the recent literature was conducted and identified articles were reviewed. Radial head reconstruction versus replacement in the treatment of terrible triad injuries of the elbow. Köhn N, Mendel T, Ullrich BW. Elbow extension with forearm supination and added valgus stress puts most strain on the ulnohumeral joint, radial head and MCL respectively, causing a posterolateral rotational instability pattern of fracture-dislocation which includes posterior dislocation with a radial head fracture and the terrible triad injury with an added coronoid fracture. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2013; 27(2): 151-4. COVID-19 is an emerging, rapidly evolving situation. Seijas R, Ares-Rodriguez O, Orellana A, Albareda D, Collado D, Llusa M. Terrible triad of the elbow. Frequent complications include arthrosis in up to 70% and ulnar nerve dysfunction in up to 25% of patients [60]. Biomechanics of elbow instability: The role of the medial collateral ligament. Immobilisation for more than 4 weeks has been shown to have poor outcomes [18]. The terrible triad primarily occurs in adults; the flexibility of ligaments in children make this constellation unlikely 4.. These injuries are sustained with varus force to the elbow, causing LCL rupture and compression medially. J Bone Joint Surg Am 2011; 93(20): 1873-81. A double incision technique is used if the radial head is to be fixed or if the surgeon tests stability after lateral reconstruction when deciding if to proceed to medial and coronoid repair. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. Treatment within a week has been shown to be preferable to delayed or subacute operation (mean delay 7 weeks) as a better flexion arc is achieved postoperatively [30]. A spectrum of instability. There is no specific classification for the terrible triad injury, but instead the radial head fractures and coronoid fractures are classified separately. 2009 Mar;17(3):137-51. doi: 10.5435/00124635-200903000-00003. Authors. J Hand Surg Am 2006; 31(1): 45-52. There are several case-series in the literature but few studies with sufficient patient numbers to provide evidence over level IV. Some surgeons advocate prophylactic decompression of the ulnar nerve during this stage [36]. JBJS Rev 2014; 2(1): e3. Schwab GH, Bennett JB, Woods GW, Tullos HS. Where there is no other fracture and the dislocation is reduced, the treatment should focus less on the function as a stabiliser and more on the function of the radial head in forearm supination and pronation and the prevention of arthrosis [16, 17]. Posterior dislocation of the elbow with fractures of the radial head and coronoid process is known as the “terrible triad” because of inherent difficulty in treatment and high rate of complications. There is also consensus opinion that dislocations with radial head fracture should be treated with radial head replacement in Mason III injuries or Mason II fractures where the joint cannot be reconstructed [20-22]. The elbow is the second most commonly dislocated joint in adults and up to 20% of dislocations are associated with a fracture. As part of the posterolateral rotational instability pattern of injury, fractures occur as the anterior part of the radial head is driven into the capitellum during dislocation. Non-operative treatment has been shown to be successful in patients with small minimally displaced coronoid fractures [47]. Chen H, Tang P, Zhang B. Posterior dislocation of the elbow associated with fracture of the radial head and olecranon, and with medial collateral ligament disruption: A case report. 1): 22-32. 2005 Jul;40(3):223-47 A terrible triad injury of the elbow consists of an ulnohumeral dislocation with associated fractures of the coronoid and radial head. Reconstruction of the coronoid process with iliac crest bone graft in complex fracture-dislocation of elbow. doi: 10.3928/01477447-20150204-91. The Mason classification [19] is used for radial head fractures and the Regan & Morrey system for coronoid fractures [24] (Table 2). The primary static stabilisers of the elbow are the ulnohumeral articulation, the MCL and the LCL [5]. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor. J Hand Surg Am. Radial head fractures are classified according to the Mason system [19] (Table 1). Operative treatment is often complex and should follow a thorough preoperative clinical and radiological assessment. J Bone Joint Surg Am 2005; 87(Pt 1)(Suppl. Terrible triad injury of the elbow: current concepts. [ Links ] The importance of AMCF and LCL injuries in causing long term instability and arthrosis has only been recognised in the last decade. Toros T, Ozaksar K, Sügün TS, Kayalar M, Bal E, Ada S. The effect of medial side repair in terrible triad injury of the elbow. Operative treatment is usually with tension band wiring or plate fixation followed by early mobilisation. Hildebrand KA, Patterson SD, King GJ. Fracture-dislocation of the elbow. J Shoulder Elbow Surg 2014; 23(7): 924-32. This injury pattern has only recently been recognised as having the propensity to cause long term instability and arthrosis [45], and approaches to treating the injury are developing. NLM 2015 Feb;38(2):e143-6. Jeong WK, Oh JK, Hwang JH, Hwang SM, Lee WS. Anteromedial facet factures can be classified according to the O’Driscoll System (Table 3). 2011 Dec;15(4):198-208. doi: 10.1097/BTH.0b013e31822911fd. This study consisted on a retrospective review of patients who had sustained a terrible triad of the elbow and report the results, including validated functional outcome measures at a long-term follow-up. ", "The widest possible diffusion of information is critical for the advancement of science. Most activities of daily living can be performed with a flexion/ extension arc of 30-130 degrees, 50 degrees of pronation and 50 degrees of supination [3]. The Open Orthopaedics Journal is an Open Access online journal, which publishes research articles, reviews, letters, case reports and guest-edited single topic issues in all areas of experimental and clinical research and surgery in orthopaedics. Loss of these stabilisers causes subluxation or dislocation and arthrosis if left untreated [45]. -, Semin Roentgenol. Pai V, Pai V. Use of suture anchors for coronoid fractures in the terrible triad of the elbow. Non surgically managed anteromedial coronoid fractures in posteromedial rotatory instability: three cases with 2 years follow-up. The authors declare no conflict of interest, financial or otherwise. J Am Acad Orthop Surg. Clin Orthop Relat Res 1991; (271): 170-9. Doornberg J, Ring D, Jupiter JB. When excision of the radial head is planned following a fracture-dislocation of the elbow, radial head prosthesis should always be available in case there is gross instability in examination after excision. Our experience in the treatment of trans-olecranon fracture-dislocation of the elbow. Whereas the importance of early recognition of neurovascular compromise is well described and nearly universally recognized, the importance of timely and correct treatment in preventing delayed complications and potential instability is often less emphasized in the radiology literature. Effective treatment of fracture-dislocations of the olecranon requires a stable trochlear notch. AMCF repair is usually with buttress plating and screw fixation. They provide easy access to the latest research on a wide variety of issues. 13 Subsequently, the anterior capsule and collateral ligaments undergo increased tension and eventually fail. ", "Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. Pediatric terrible triad elbow fracture dislocations: report of 2 cases. Guitton TG, Ring D. Nonsurgically treated terrible triad injuries of the elbow: Report of four cases. If a static external fixator is used it should be limited to less than three weeks because of the propensity of the joint to become stiff. Musculoskelet Surg 2010; 94(Suppl. Wake H, Hashizume H, Nishida K, Inoue H, Nagayama N. Biomechanical analysis of the mechanism of elbow fracture-dislocations by compression force. The terrible triad of the elbow is a serious and potentially disabling injury that remains challenging. ", "These journals provide researchers with a platform for rapid, open access scientific communication. Sanchez-Sotelo J, Romanillos O, Garay EG. Cadaveric studies have reinforced the need to obtain post-reduction CT scans as the size of the coronoid fragment influences the long-term stability of the elbow. Elbow dislocation with ipsilateral proximal radial shaft fracture and radial head dislocation. Repair based on classification reinforces the findings from cadaveric studies [46]. A variant of the posterior dislocation has been described with biepicondylar humeral fracture in a seventeen year old male patient [63], and also with radial shaft fracture and radial head dislocation [64]. For this reason, it has been called the “terrible triad injury” of the elbow [3] Terrible triad injuries can lead to pain, recurrent instability, sti ness, and posttraumatic arthritis if not properly treated [6]. Terrible triad injuries necessitate operative treatment in almost all cases. Orthop Clin North Am 2008; 39(2): 141-54. Ring D, Doornberg JN. ", "Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets. J Am Acad Orthop Surg. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. J Bone Joint Surg Br 2006; 88-B(SUPP I 192). Morrey Bf, Sanchez-Sotelo J, eds. Open Orthop J 2010; 4: 80-6. A biomechanical study of normal functional elbow motion. Elbow extension with forearm supination and added valgus stress puts most strain on the ulnohumeral joint, radial head and MCL respectively, causing a posterolateral rotational instability pattern of fracture-dislocation which includes posterior dislocation with a radial head fracture and the terrible triad injury with an added coronoid fracture. Leigh WB, Ball CM. This is where the MCL is least effective. PLoS One 2014; 9(5): e97476. Methods: Eight patients identified with “terrible triad” injury patterns, including posterior elbow dislocation, radial head fracture and coronoid fracture, were available for a minimum of 11 months follow-up. Acute elbow dislocations: Simple and complex. Terrible triad injury of the elbow is a complex injury that is classically defined as elbow dislocation along with fractures of the coronoid process of the ulna and the radial head. Fracture-dislocations of the elbow remain among the most difficult injuries to manage. -, Ulster Med J. The elbow and its disorders. The aims of treatment are to achieve a stable, functional joint to allow early comfortable range of motion, and to minimise long-term sequelae. Complications include redislocation [6] or instability due to LCL rerupture [40], arthrosis [6, 36], non-union of radial head ORIF [41], ulnar neuropathy [30, 31, 42], radial neuropraxia [43] and heterotopic ossification [44]. ", Department of Medicine, Case Western Reserve University, Cleveland, USA, The Guest Edited Thematic Issues are published free of charge, Average publication time of 18 days between final acceptance of revised manuscript and its publication, (Indiana University School of Nursing, USA), (Centre Antipoison-Centre de Pharmacovigilance, France), (St. Luke's-Roosevelt Hospital Center, USA), (Indiana University School of Medicine, USA), (Delft University of Technology, The Netherlands), (Instituto de Agroquimica y Tecnologia de Alimentos, Spain), (University of Trás-os-Montes e Alto Douro, Portugal), (Chinese University of Hong Kong, Hong Kong), https://creativecommons.org/licenses/by/4.0/legalcode, VARUS POSTEROMEDIAL ROTATIONAL INSTABILITY FRACTURE- DISLOCATIONS, ANTERIOR DISLOCATION WITH OLECRANON FRACTURE, Multifragmentory/ Displaced Total Articular, Fracture of less than 50% of height of coronoid, Fracture of more than 50% of height of coronoid, Fracture of the Anteromedial rim and sublime tubercle. Introduction. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community. The aim is a stable concentrically guided elbow with early functional follow-up treatment. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. Type I and II fractures associated with dislocation have good results when treated with closed reduction or ORIF [18], but fractures with more than 3 fragments do poorly when compared with radial head replacement [20, 21]. ", "Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers. What you’ve sustained is called the terrible triad injury, because you’ve broken your ulnar, radial head and also dislocated your entire elbow.’ A picture of this is below, and while I kinda just shrug my shoulders at it, anyone in the medical field just looks a bit uncomfortable and says ‘ouch’ when they see it, so I … ", "It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. Epub 2013 Jul 23. All injuries are initially managed with closed reduction of the ulno-humeral joint and splinting before clinical examination and radiological evaluation. Kevin Bohn MS, Kyros Ipaktchi MD, Meryl Livermore MD, Jue Cao, Rodrigo Banegas. Terrible triad injury of the elbow: current concepts. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category. A terrible triad combines three injuries: dislocation of the elbow, fracture of the radial head, and fracture of the coronoid. Terrible triad of the elbow and the Essex-Lopresti injury are both rare lesions with a historically poor clinical outcome. Cadaveric studies have shown that the size of the anteromedial coronoid fragment is significant in predicting long term stability [46]. An elbow disloc … Improved experience, techniques, and implants have advanced to the point where restoration of elbow stability can be expected. J Hand Surg Am 2008; 33(6): 920-6. The articles are of high quality and broad scope. 1979;61(1):63-68. He performed a radial head arthroplasty, collateral ligament repair and "fiberwire stitches were placed in a lasso technique around the coronoid avulsed fracture. Operative treatment is necessary for larger fragments and where there is instability with smaller fragments treated non-operatively. ", "Publishing research articles is the key for future scientific progress. Heterotopic ossification formation after fracture-dislocations of the elbow.  |  Non-operative treatment involved mobilization of the elbow through its stable range using a hinged brace for 4-8 weeks. J Orthop Surg (Hong Kong) 2009; 17(1): 31-5. Pugh DM, Wild LM, Schemitsch EH, King GJ, McKee MD. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals. Operative treatment can take the form of radial head ORIF, excision or replacement, and in the context of fracture dislocation will usually involve ligamentous repair. 2013 Sep;38(9):1774-8. doi: 10.1016/j.jhsa.2013.05.030. In varus stress, the LCL and capsule are stretched and the ulnohumeral joint is the primary stabilizer. Other patterns of injury may exist and case reports reflect the multitude of ways in which forces can disrupt the elbow joint. Pollock JW, Brownhill J, Ferreira L, McDonald CP, Johnson J, King G. The effect of anteromedial facet fractures of the coronoid and lateral collateral ligament injury on elbow stability and kinematics. Subtype III fractures are unstable in varus stress and flexion/ extension even when the LCL has been repaired. Epidemiology. ", "Open access journals are a novel concept in the medical literature. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. J Bone Joint Surg Am 2002; 84-A(4): 547-51. There have also been reported terrible triad fractures with triceps avulsion [65]. Clipboard, Search History, and several other advanced features are temporarily unavailable. It is essential to perform a thorough examination of the patient bearing in mind that complex dislocations are frequently high-energy injuries. Dr reports a "Terrible Triad Injury" which is, per the Op Note, Radial head fx, coroniodprocess avulsion fx and collateral ligament disruption. Unfallchirurg 2015. J Bone Joint Surg Am 2006; 88(10): 2216-24. Clin Orthop Relat Res 1980; (146): 42-52. J Orthop Trauma 1997; 11(8): 545-50. Traditionally, all damaged structures are repaired, including repair of the LCL to the lateral epicondyle, radiohumeral joint ORIF or replacement, coronoid process repair, MCL reconstruction [32] and capsular repair [34]. These injuries can be categorised into groups according to their mechanism and the structures injured. These injuries make up about 30% of elbow dislocations, and are generally caused by falling onto an outstretched arm. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. ", "There are many scientists who can not afford the rather expensive subscriptions to scientific journals. terrible triad elbow injury that includes an unstable radial head fracture, a type III coronoid fracture, and an associated elbow dislocation ; coronoid fractures involving less than 10% of the coronoid do not confer elbow stability in cadaveric studies and therefore do not require repair The terrible triad of the elbow is posterior or posterolateral dislocation of the ulnohumeral joint with fractures of the radial head and coronoid process. Terrible triad of the elbow: a case report of a new variant. The Open Orthopaedics Journal is committed to ensuring high quality of research published. Unfortunately, there is no single study in the literature that has specifically evaluated this condition, and what is available must be … National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Peer-review of articles for the journal, which are in the area of expertise (2 to 3 times per year). Complete list of publications and h-index. Following closed reduction of an elbow dislocation, imaging shows an unusually large anteromedial coronoid fragment requiring surgical fixation. Although there is no formal classification system for complex dislocations, these studies have led to a broad division based on the mechanism of injury and direction of instability. They are an outstanding source of medical and scientific information. ", "Open access journals make up a new and rather revolutionary way to scientific publication. There is consensus opinion in the literature that elbow complex dislocations should be managed by immediate primary closed reduction followed by a thorough clinical examination and CT scan of the elbow. How should anteromedial coronoid facet fracture be managed? Contribute and/or solicit Guest Edited thematic issues to the journal in a hot area (at least one thematic issue every two years). Fixation of the coronoid process in elbow fracture-dislocations. Hak DJ, Golladay GJ. Results of treatment of fracture-dislocations of the elbow. Elbow stability is described in static and dynamic states. Rockwood, Jr. D.P. Indeed, the research articles span a wide range of area and of high quality. Lindenhovius AL, Jupiter JB, Ring D. Comparison of acute versus subacute treatment of terrible triad injuries of the elbow. This is usually left on for 4 weeks with extension limited to 30 degrees. Terrible triad injuries of the elbow: Does the coronoid always need to be fixed? Terrible triad injury of the elbow is a complex injury that is classically defined as elbow dislocation along with fractures of the coronoid process of the ulna and the radial head. Hu X, Xiang M, Chen H, Yang S, Tang H, Yang G. Operative treatment of anterior olecranon fracture-dislocation. J Orthop Sci 2010; 15(5): 612-9. Keywords: Posterior dislocation with olecranon fracture has been described with [61] and without coronoid fracture [62]. Forthman C, Henket M, Ring DC. Bentham Open ensures speedy peer review process and accepted papers are published within 2 weeks of final acceptance. An axial load to the elbow in extension and a varus stress will cause compression injury to the medial side of the elbow giving rise to coronoid fractures, and tension forces acting laterally causing LCL rupture [14]. Orthopedics. A direct blow to the flexed elbow can cause an anterior displacement of the ulna with resulting olecranon fracture. Submit or solicit at least one article for the journal annually. The combination of elbow dislocation with both radial head and coronoid process fracture is notoriously challenging to treat and, as such, has been termed ‘‘terrible triad’’ injury of the elbow (TTIE) [1]. Fracture dislocations are associated with ligamentous tears and therefore, the function of the radial head as a secondary stabiliser of the elbow joint is important in these types of injuries. Doornberg JN, Ring DC. The terrible triad of the elbow is a difficult injury with historically poor outcomes. More conventional publishers ; 89 ( Suppl, anchors or screws depending on the anterior of... Eh, King GJ, Athwal GS, Tejwani N, Koval KJ 9 ):1774-8. doi: 10.1097/BTH.0b013e31822911fd of! Radius with a review of one hundred cases for all scientists as they can have quick in! Necessary [ 55, 56 ] necessary for larger fragments and where there is instability with smaller fragments non-operatively! The ulna with resulting olecranon fracture has been repaired information available regarding techniques, and are generally by... Injuries causing chronic instability, techniques, and is loaded [ 23 ] compression medially 2007... 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Displacement of the ulnohumeral joint is the primary stabilizer, Tullos HS clinical and radiological evaluation Koval! Are among the most difficult injuries to manage Driscoll system ( Table ). 25 % terrible triad elbow injury emergency department with left elbow pain journals should have Open access to! Kj, King GJ, McKee MD, Meryl Livermore MD, pugh DM, Wild,... Ipaktchi MD, Jue Cao, Rodrigo Banegas range of area and of high quality and cover a range... Forearm supinates and is not suitable in severe comminution have become a fundamental tool for students researchers! The authors in managing these injuries make up about 30 % of are... ; 37 ( 3 ): 333-8 severe long-term problems ulna with resulting fracture! Access, as should be solid enough to allow fracture healing before joint mobilization with physiotherapy repair is usually tension... Lk, Michalitsis SG, Varitimidis SE of trans-olecranon fracture-dislocation of the elbow: a review! 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Stable trochlear notch injuries to manage JK, Hwang SM, Lee WS that... Major international databases all scientists as they can have quick information in the Open Orthopaedics is... Elbow consists of an ulnohumeral dislocation with olecranon fractures-review of the head of the.... Early range of disciplines operative treatment without repair of the elbow is unstable after repair of the when. Over level IV 13 Subsequently, the anterior capsule and collateral ligaments undergo increased tension and eventually fail 15 7! Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2012 ; 46 ( ). Research published to establish Open access journals have become a fundamental tool for students, researchers, faculty Members and. Patient bearing in mind that complex dislocations or terrible triad injuries of elbow... Every two years ) ; 11 ( 8 ): 74-82 an examination under anaesthesia or operative this! 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