Year: 2025
Type: article
Study design: Case Report
Abstract: This case report presents a rare and complex elbow injury that expands the conventional scope of the "terrible triad" pattern. A 21-year-old male sustained high-energy trauma resulting in posterior elbow dislocation, radial head and coronoid process fractures, intra-articular distal humerus fractures involving the trochlea and capitellum, and a midshaft ulna fracture. Surgical management was performed using the posterior trans olecranon approach. The ulnar shaft fracture was stabilized by using a locking reconstruction plate and interfragmentary screw fixation. Intra-articular fractures were reduced and fixed using Herbert screws followed by dual-column plating of the distal humerus. The lateral collateral ligament was repaired, and olecranon osteotomy was fixed with tension-band wiring. A structured rehabilitation protocol was implemented postoperatively. At nine months, the patient returned to light activity with fair range of motion and no complications. This case highlights the importance of individualized surgical planning and early rehabilitation in managing complex elbow injuries that transcend the traditional definition of the terrible triad. The use of a trans-olecranon approach, stable fracture fixation, and anatomical articular reconstruction are the key elements for achieving satisfactory functional outcomes.
Authors: Devinder Kumar, Kunal Goel, Lokesh Thakur, Virender Singh, Neelam Kumari
Institution: Dr. Rajendra Prasad Government Medical College
Language: English
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413729577