Terrible triad injury

Overview

what it is and why it matters

Labeled diagram of the upper-extremity bones showing the humerus, radius, and ulna meeting at the elbow. — **Elbow anatomy.** The elbow is a hinge joint between the upper-arm bone (humerus) and the two forearm bones (radius and ulna). It allows the forearm to bend and straighten, and the radius rotates around the ulna to turn the palm up and down.

The "terrible triad" of the elbow — posterior dislocation combined with fractures of the coronoid and the radial head — represents the most unstable and surgically demanding elbow injury. The combination disrupts every stabilizer of the elbow: the bony buttresses (coronoid and radial head), the medial and lateral ligamentous complexes, and the anterior capsule. Without surgical reconstruction of all injured structures, the elbow will re-dislocate.

Diagnosis

exam first, imaging second

High-energy elbow injury with obvious deformity. Post-reduction CT is essential to characterize both fractures and plan staged reconstruction. Careful neurovascular examination is mandatory.

Treatment Path

how care progresses at OSI

Emergency closed reduction

Initial reduction of the dislocation, followed by imaging and surgical planning.

Surgical Options at OSI

if non-operative care isn't enough

All terrible triad injuries require surgical repair/fixation to achieve a stable, functional elbow.

Overview

Diagnosis

Treatment Path

Emergency closed reduction

Surgical Options at OSI

Providers Who Treat Terrible Triad Injury

Michael S. Vrana, M.D.

David B. Templin, M.D.

Trent Twitero, M.D.

Further Reading

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