Evaluation of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow

Wu, Xulin; Tang, Bo‐Hui; Zhu, Weimin; Zhou, Guangfu; Liu, Fuyao; Qiu, Bing; Chen, Hongwei; Wang, Zi-Yang

doi:10.1097/md.0000000000006819

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…Traumatic injuries are traditionally managed with the use of lateral or medial exposure [ 22 ]. The combination of the posterior lateral and anterior approaches could improve the activity of the elbow, the Mayo Elbow Performance Score, and visual analog scale results, and the success rate while reducing the postoperative healing time and the complication rate, making this compound approach a clinically effective approach, which was consistent with our findings [ 23 ]. However, some defects in the anterior approach were noted, including a very larger diameter of the anterior approach and an increase in bone loss following re-expansion of the operation [ 18 ].…”

Section: Discussionsupporting

confidence: 90%

A comparative study on the validity and reliability of anterior, medial, and posterior approaches for internal fixation in the repair of fractures of the coronoid process of the ulna

Chen

Teng

2018

Eur J Med Res

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BackgroundThe coracoid process plays an important role in maintaining the stability of the elbow joint. A fracture of the coronoid process is often treated via surgical approaches, including open reduction and internal fixation, which aim to regain a stable, flexible, and loadable joint. In this study, we compared the anterior, medial, and posterior approaches of internal fixation in the repair of fractures of the coronoid process of the ulna.MethodsIn this retrospective study, 147 patients with fractures in the coronoid process of the ulna were recruited and classified into the anterior group (n = 73), the medial group (n = 32), and the posterior group (n = 42) according to the surgical approach used for internal fixation. These patients were assessed with respect to incision, operative time, estimated blood loss, fracture healing, and postoperative complications. The Mayo Elbow Performance Score was used to evaluate any form of disability associated with elbow injuries. Multivariate logistic regression analysis was performed to investigate the factors influencing the efficacy of fractures of the coronoid process of the ulna.ResultsIn the medial approach group, the operative time was longer, and perioperative blood loss and postoperative drainage volume were obviously increased compared with the anterior and posterior groups. The anterior group exhibited a better postoperative recovery compared with the medial, and posterior groups. Compared with the anterior group, fracture-healing time in the posterior group was further reduced, whereas elbow joint flexion extension and forearm rotation degree improved. Complications were significantly reduced in the posterior approach group compared with the anterior and medial groups. The factors influencing the efficacy of fractures of the coronoid process of the ulna included the Regan–Morrey classification, perioperative blood loss, and the internal fixation approach.ConclusionIn summary, the approach used influences fracture healing or the outcome after osteosynthesis. The posterior internal fixation method produced satisfactory functional outcomes in patients with fractures of the coronoid process of the ulna.

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Section: Discussionsupporting

confidence: 90%

A comparative study on the validity and reliability of anterior, medial, and posterior approaches for internal fixation in the repair of fractures of the coronoid process of the ulna

Chen

Teng

2018

Eur J Med Res

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“…In the article, “Evaluation of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow: A retrospective study”, [ 1 ] which appeared in Volume 96, Issue 24 of Medicine , in the following sentences, “Affiliated YiWu Hospital of Wenzhou Medical University” should have appeared as “Guizhou Province Orthopedics Hospital.”…”

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confidence: 99%

Evaluation of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow

2017

Medicine

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“…[18] Patients undergoing surgical treatment through a combined posterior lateral and anteromedial approach, however, showed increased fracture healing rate, improved elbow functioning, and decreased incidence of complications. [13] Similarly, another research demonstrated that surgical treatment regimens for terrible triad of elbow joint, such as radial head arthroplasty, repairing the coronoid or the joint capsule, and repairing the lateral ligament complex of the elbow, accomplished good results in majority patients, which was independent from treatment for radial head fractures. [19] Moreover, it was found that the hinged external fixator technique fared superior results compared to other treatments, because it aided lateral stability of elbows and functioning of the elbow joint in addition to decrease elbow stiffness and heterotopic ossification.…”

Section: Discussionmentioning

confidence: 99%

“…[12] A previous study found that a combined posterior lateral and anteromedial approach achieved good results in the treatment of terrible triad of the elbow joint with increased fracture healing rate, improved recovery of elbow functions, and decreased complications. [13] Moreover, restoration of the radial head, coronoid, medial, and lateral collateral ligaments through operative treatment has been known to help recover elbow stability, allow early postoperative motion and promote the recovery of elbow functions. [14] Therefore, the present study aims to compare conventional treatment with surgical treatment for terrible triad of the elbow joint, and analyze the related factors affecting surgical efficacy.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of efficacy for patients receiving surgical treatment following terrible triad of the elbow joint

Chen

Huang

2019

Medicine

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Background:This study aims to explore the efficacy of surgical and conservative treatment for elbow joint terrible triad, and evaluate related factors affecting surgical treatment efficacy.Methods:Patients with terrible triad of elbow joint (n = 165) were selected, among which 79 cases underwent conservative treatment (the control group) and 86 cases underwent surgical treatment (the experimental group). The range of flexion and extension, range of rotation and Mayo elbow performance score were recorded. In the experimental group, postoperation, according to the Mayo elbow performance score, patients were assigned into the effective group (72 cases) and ineffective group (14 cases). All patients were followed up regularly for 6 to 24 months. X-ray and computed tomography examination were used to examine anterior and posterior elbow joints preoperatively and postoperatively and the degree of arm rotation.Results:The range of flexion and extension, range of rotation and Mayo elbow performance score were found to be significantly higher in the experimental group after treatment compared to the experimental group before treatment and in the control group after treatment. Seven days after treatment, compared with the control group, the expressions of interleukin (IL)-6, C-reactive protein, IL-8, and tumor necrosis factor-α in serum decreased, and returned to almost near normal levels in the experimental group. Age, mean operative time, and postoperative immobilization time were significantly different between the effective and ineffective groups. The incidence of joint stiffness, heterotopic ossification, and ulnar nerve symptoms in the effective group were lower than those in the ineffective group. The postoperative immobilization time served a protective factor for the efficacy of surgical treatment of elbow joint terrible triad, while age served as a risk factor.Conclusion:The results indicated that surgical treatment regimens for elbow joint terrible triad exhibited better efficacy than conservative treatment regimens, and lower age and longer postoperative immobilization time serve as protective factors for surgical treatment efficacy.

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Evaluation of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow

Cited by 9 publications

References 15 publications

A comparative study on the validity and reliability of anterior, medial, and posterior approaches for internal fixation in the repair of fractures of the coronoid process of the ulna

A comparative study on the validity and reliability of anterior, medial, and posterior approaches for internal fixation in the repair of fractures of the coronoid process of the ulna

Evaluation of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow

Risk factors of efficacy for patients receiving surgical treatment following terrible triad of the elbow joint

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