Comprehensive management of the terrible triad of the elbow: case-specific insights and outcomes

BACKGROUND: The terrible triad of the elbow is a complex injury involving elbow dislocation, radial head fracture, and coronoid process fracture. The aim of this study was to evaluate long-term functional recovery and complications across various treatments. METHODS: A retrospective analysis of 35 patients treated from 2011 to 2021 was conducted. Functional recovery and disability were assessed using the Mayo Elbow Performance Score (MEPS) and Disability of the Arm, Shoulder, and Hand (DASH) Score. RESULTS: Over half of the patients achieved excellent MEPS scores (>90). The average MEPS was 86.57±17.14, and the average DASH Score was 20.89±23.27. Complications occurred in 67% of cases, mostly minor, including joint stiffness and ulnar neuropathy. No significant difference was observed between internal fixation and prosthesis treatments (P=0.1221). CONCLUSIONS: The terrible triad of the elbow can be effectively managed with surgical or non-surgical approaches, with satisfactory outcomes. However, the high rate of minor complications calls for individualized treatment strategies and further research to improve guidelines.