Management of Terrible Triad Injuries

Description

In this presentation, Bijayendra Singh discusses the management of the Terrible Triad, a complex and unstable elbow injury. He begins by introducing himself and thanking the organizers for the opportunity to speak. The Terrible Triad consists of three injuries: an elbow dislocation, a coronoid fracture, and a radial head fracture, which collectively increase the instability of the elbow and complicate treatment. Singh emphasizes the relative rarity of the injury and the poor understanding that often surrounds it, leading to suboptimal outcomes.



Throughout the presentation, Singh details the anatomy involved, the importance of accurate imaging (including radiographs and CT scans), and the surgical principles necessary for effective management. He elaborates on the repair techniques needed, emphasizing the restoration of stability, protection of reconstructions, and potentially using external fixators. Various classifications for fractures are discussed, alongside specific case examples that illustrate the challenges and surgical options for each component of the Terrible Triad.



Singh provides insights into the surgical approaches, discussing lateral and medial techniques, and highlights the critical role of proper placement and fixation for both the coronoid and radial head. He also advises on postoperative care and rehabilitation strategies to ensure successful outcomes, reinforcing the necessity of early mobilization under supervision. The presentation concludes with key takeaways and a flowchart for surgical planning, addressing the considerations involved in complex elbow injuries and the importance of careful preoperative planning.

Specialties