Protocolised surgical treatment of terrible triad of elbow. Results and complications

Autor: D. Cecilia López, L. García Lamas, V. Jiménez Díaz, M.A. Porras Moreno, Juan María Pardo García, M. Álvarez Muñoz
Rok vydání: 2019
Předmět:
Zdroj: Revista Española de Cirugía Ortopédica y Traumatología (English Edition). 63:281-288
ISSN: 1988-8856
DOI: 10.1016/j.recote.2019.02.003
Popis: Background Terrible triad of elbow is a complex lesion with a high rate of complications. Our goal is to analyse both clinical results and complications after performing protocolised surgery. Material and methods We performed a prospective longitudinal study using our hospital database. We obtained a total of 62 triads. The initial approach was lateral and when necessary we added a medial approach. We treated 3 main pillars, the radial head, the coronoid process, and the lateral collateral ligament. If needed, we repaired the medial collateral ligament or we performed an external fixator. Results In our series, the radial head was synthesised in 14 (22.5%), an arthroplasty was performed in 45 (72.5%), and other actions in 3 (5%). The coronoid could be synthesised in 12 (19.3%). In 41 (66.2%) a transosseous suture or an anchor were performed, and in 9 (14.5%) no treatment was given. The LCL was repaired in 100% of cases, in 9 (14%) the MCL had to be repaired, and 22% of the patients required Ex-Fix. There were 17 (27%) complications. Three (17.5%) cases of infections, 4 (23.5%) neurological lesions, 3 (17.5%) cases of stiffness, 1 (6%) ulnar impaction syndrome, and 1 (6%) case with an intraarticular fragment postoperatively. Four (23.5%) heterotopic ossification, and 1 (6%) osteolysis of radial prosthesis were observed. Regarding functional results, range of mobility (ROM) of 120°/−20° flexo-extension, and 98°/85° of prono-supination were obtained. Conclusions Elbow triads are complex lesions where protocolised surgery is necessary, nevertheless the complication rate was 27% in our series.
Databáze: OpenAIRE
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