Klug Alexander, Sauter Matthias, Hoffmann Reinhard
BG Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt, Deutschland.
Unfallchirurgie (Heidelb). 2023 Sep;126(9):679-686. doi: 10.1007/s00113-023-01321-0. Epub 2023 Apr 28.
The complex injury pattern of a posterior elbow dislocation with concomitant radial head and coronoid fractures is usually referred to as a terrible triad injury. Due to the concomitant compromise of several osteoligamentous structures of the elbow joint relevant for stability, these injuries pose a particularly major challenge to the treating trauma surgeons. For this reason, a careful preoperative analysis of all relevant injury components is mandatory in order to make an adequate treatment decision. In most cases, surgical treatment addressing all elements relevant for stability is necessary to achieve a stable and congruent elbow joint. Only this enables early functional follow-up treatment and minimizes the complication rate. Delayed or even insufficient treatment with persistent (sub)dislocation must be avoided at all costs, otherwise there is a high risk of serious posttraumatic functional disorders of the elbow with rapid progression of osteoarthritis.
伴有桡骨头和冠突骨折的肘关节后脱位的复杂损伤模式通常被称为可怕三联征损伤。由于肘关节几个与稳定性相关的骨韧带结构同时受损,这些损伤给创伤外科医生带来了特别大的挑战。因此,必须对所有相关损伤成分进行仔细的术前分析,以便做出适当的治疗决策。在大多数情况下,针对所有与稳定性相关的因素进行手术治疗对于实现稳定且关节面一致的肘关节是必要的。只有这样才能进行早期功能随访治疗并将并发症发生率降至最低。必须不惜一切代价避免延迟治疗甚至治疗不足导致持续性(亚)脱位,否则肘关节严重创伤后功能障碍并迅速发展为骨关节炎的风险很高。