Terrible triad elbow fracture-dislocation

Job N. Doornberg, David Ring, Gregory Bain

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


The coronoid process of the ulna is an important bony stabilizer of the elbow forming an anterior buttress with the radial head to avoid posterior subluxation or dislocation of the elbow (Fig. 38.1). Specific fracture types are associated with distinct patterns of traumatic elbow instability. Coronoid fractures are classified using the O’Driscoll classification based on fragment morphology: type 1 are tip fractures associated with terrible triad elbow fracture-dislocations, type 2 are anteromedial facet fractures associated with posteromedial varus rotational-type injuries (PMVRI), and type 3 are large basal fracture associated with olecranon fracture-dislocations.

They can be difficult to manage. Improved understanding of these patterns of elbow instability facilitates operative strategies by helping surgeons anticipate the pathoanatomy and plan treatment. These injuries are prone to adverse events and adverse outcomes including subluxation and redislocation, malunion, nonunion, arthrosis, stiffness, and heterotopic ossification.
Original languageEnglish
Title of host publicationSurgical Techniques for Trauma and Sports Related Injuries of the Elbow
EditorsGregory Bain, Denise Eygendaal, Roger P. van Riet
Place of PublicationBerlin
Number of pages9
ISBN (Electronic)9783662589311
ISBN (Print)9783662589304
Publication statusPublished - 2020


  • Elbow fracture-dislocation
  • Coronoid fracture
  • Radial head fracture
  • Lateral collateral ligament injury
  • Medial collateral ligament injury


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