Anterior Elbow Dislocation with Radial Neck Fracture- A Variant of the Terrible Triad and a Review of the Literature

¹Department of Orthopaedic Surgery, National University Hospital, Singapore.
²Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.

Corresponding Author: Yau Hong Ng, Department of Orthopaedic Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore, Tel: +6598224218; E-Mail: [email protected]

Received Date: 27 Feb 2017   
Accepted Date: 20 Mar 2017  
Published Date: 22 Mar 2017

Copyright © 2017 Ng YH

Citation: Ng YH and Tan DMK. (2017). Anterior Elbow Dislocation with Radial Head Fracture- A Variant of the Terrible Triad And a Review of the Literature. Mathews J Orthop. 2(1): 014.

ABSTRACT

Terrible triad injuries of the elbow typically present as posterior elbow dislocations with an associated radial head and coronoid fracture. We report an atypical presentation of this injury pattern with an anterior dislocation of the elbow with a radial neck and coronoid tip fracture, as well as a humeral avulsion of the lateral ulnar collateral ligament (LUCL). This patient underwent open reduction and internal fixation of her radial neck fracture and suture anchor fixation of the avulsed LUCL through a lateral approach to the elbow. She has since regained painless and functional range of motion of her elbow. This case highlights the importance of the injury mechanism, fracture pattern and intraoperative stress tests in identifying the crucial injured components of the elbow. Addressing the bony injuries alone without reconstituting the soft tissue restraints of the elbow would invariably lead to persistent instability, arthrosis and poor outcome.

KEYWORDS

Terrible Triad; Atypical Presentation; Variant Patterns; Radial Neck Fracture; Literature Review.