The Timing of Surgery Affects the Treatment of the Terrible Triad of the Elbow: A Recent Study

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The Timing of Surgery Affects the Treatment of the Terrible Triad of the Elbow: A Recent Study

The terrible triad of the elbow can be managed in the better way if treated early or in the emergency. The TTE refers to the elbow dislocation which results in radial head and coronoid process fractures. The injury further can lead to complications like joint instability, pain or arthritis. Thus, Dr Chengwei Zhou and colleagues conducted a study to examine the therapy timing effect on the terrible triad of the elbow (TTE) treatment.

The study involved the total of 63 patients, categorized into three groups. The group A was the emergency group (20 patients) who received therapy within 24h after injury. Group B was the early surgery group (26 patients) who got treatment within 4 to 14 days after injury. Group C was the delayed surgery group (17 patients) who received treatment 14 days after the injury. All groups went through the same treatment. The motion of the elbow and complexity rates were also compared and recorded.

Out of 63 patients, the follow up is done for 58 patients (mean 20.5±1.9 months) as 5 lost, incomplete final data. One month after the surgery, group A exhibited better elbow motion than group B and C (P<0.01).

Although, after 3 months and later, the group B (P>0.05) also showed better elbow motion as group A. However, no better improvements were seen in group C (P<0.05).  The elbow motion was noticed at the final clinical visit. In both groups, A and B, the MEPS (Mayo Elbow Performance score) was also high with better elbow movements as compared to group C (all P<0.05).

Although, no postoperative complications differences were observed among all 3 groups. The group A showed 2, B showed 3 and C showed 7 elbow stiffness cases.  All these cases required reoperation to improve elbow function. Rest group A and B better results from all perspectives. The study concluded as the TTE should be treated as soon as possible as it is hard to manage the condition in delayed treatment.  


Med Sci Monit.


Original title of article:

Does Timing of Surgery Affect Treatment of the Terrible Triad of the Elbow?


Chengwei Zhou et al.

Exploratory, Arthritis, Elbow joint
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