Comparison of different approaches in the treatment of terrible triad of the elbow

Abstract

Objective To compare the curative effect of two kinds of approaches in patients with terrible triad of the elbow. Methods From Mar. 2013 to Jul. 2016, a total of 33 patients with terrible triad of the elbow in our hospital were taken as the clinical research objects, and were divided into group A (18 cases, combined internal and external approach operation) and group B (15 cases, posterior approach operation). The healing time of elbow joint and postoperative complications were compared between the two groups, and the result of joint function evaluation (Mayo elbow function scale) 1 year after operation and the changes of range of motion before and after operation were recorded. Results The healing time of elbow joint in group B was significantly shorter than that in group A [(16.1±2.1) weeks vs.(18.2±3.2) weeks, P 0.05). After operation, the elbow flexion and extension mobility [(120.1±21.5)° vs.(78.0±15.8)°, (124.5±28.9)° vs.(78.3±14.6)°] and forearm rotation mobility [(103.5±14.2)° vs.(60.2±13.1)°, (105.6±10.3)° vs.(58.9±14.2)°] in the two groups were significantly improved compared with those before treatment (P 0.05). The incidence of postoperative complications in group A was significantly lower than that in group B (16.7% vs.53.3%, P<0.05). Conclusions The two kinds of surgical methods are both beneficial to the prognosis of patients with terrible triad of the elbow; patients with combined internal and external approach operation have slower recovery but lower risk of complications, and patients with posterior approach operation have faster recovery but higher risk of complications. There are advantages and disadvantages in the two surgical approaches for the treatment of terrible triad of the elbow, therefore proper approach should be chosen according to patients' condition and medical history. Key words: Approach; Terrible triad of the elbow; Curative effect; Elbow function