Diagnosis and treatment of elbow triad
10.3760/cma.j.cn121113-20250218-00151
- VernacularTitle:肘关节三联征的诊断与治疗
- Author:
Yejun ZHA
1
;
Jianyu ZHANG
1
;
Xieyuan JIANG
1
Author Information
1. 首都医科大学附属北京积水潭医院创伤骨科，北京 100035
- Publication Type:Journal Article
- Keywords:
Elbow joint;
Fractures, bone;
Dislocations;
Fracture fixation, internal
- From:
Chinese Journal of Orthopaedics
2025;45(13):897-902
- CountryChina
- Language:Chinese
-
Abstract:
Elbow Triad refers to an elbow dislocation combined with fractures of the radial head and the coronoid process, representing a complex elbow injury. Management of the elbow triad is challenging and often yields poor outcomes, frequently leading to complications such as elbow instability, ulnar nerve injury, and elbow stiffness. The injury mechanism of the elbow triad typically involves a fall on an outstretched arm, subjecting the forearm to supination, axial loading, and valgus stress. This force sequence results in progressive disruption of the elbow's anatomical structures from lateral to medial. Diagnosis requires particular attention to imaging assessment, and special attention should be paid to differentiating coronoid process fractures from elbow dislocation. Currently, there is no independent classification system, and diagnosis often relies on the modified Mason classification for radial head fractures and the Regan-Morrey and O'Driscoll classifications for coronoid process fractures. Non-surgical indications must be strictly defined and include: congruent joint reduction, absence of bony block to motion, a small or non-displaced coronoid fracture fragment, and inherent elbow stability. For the majority of cases requiring surgical treatment, a lateral approach is recommended, with a combined over-the-top approach when necessary. During surgery, the coronoid process fracture, radial head fracture, and lateral soft tissues should be addressed sequentially, with restoration of stability being crucial. Postoperative care should include early functional exercises and pay attention to preventing complications such as elbow instability, traumatic elbow stiffness, and ulnar nerve injury.
