title: Evaluation of the results from surgical treatment of the terrible triad of the elbow.
abstract: OBJECTIVE
  to evaluate the results from surgical treatment of the terrible triad of the elbow (fracture of the radial head, fracture of the coronoid process and elbow dislocation) and its complications.
  
  
  METHODS
  between August 2002 and August 2010, 15 patients (15 elbows) with the terrible triad were treated by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo. Nine (60%) were male and six (40%) were female; their ages ranged from 21 to 66 years, with a mean of 41 years. With the exception of one case that underwent arthroscopic surgery, all the patients underwent open surgery. The fracture of the coronoid process was fixed in 10 patients (66.7%). The fracture of the radial head was treated by means of internal osteosynthesis in 11 cases (73.3%); in three cases (20%), the radial head was resected; and in one case, only the fragment of the fracture was resected. The collateral ligaments, except for one case, were repaired whenever they were found to be injured; ten cases (66.7%) of medial collateral injury and 15 (100%) of lateral collateral injury were found. The mean length of the postoperative follow-up was 62 months, with a minimum of 12 months. The postoperative evaluation was done by means of the Bruce score.
  
  
  RESULTS
  more than 80% of the patients recovered their functional ranges of motion but, according to the Bruce score, only 26% of the patients achieved results that were considered satisfactory.
  
  
  CONCLUSIONS
  despite the unsatisfactory results, the functional ranges of motion and elbow function could be restored.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Alberto
authors.initials: A
authors.lastname: Naoki Miyazaki
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Caio
authors.initials: C
authors.lastname: Santos Checchia
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fagotti
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Fregonez
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Doneux Santos
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Luciana Andrade
authors.initials: LA
authors.lastname: da Silva
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Guilherme
authors.initials: G
authors.lastname: do Val Sella
authors.affiliation: Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Luiz Checchi
keywords: Elbow/injuries; Elbow/surgery; Internal fracture fixation