Conservative Treatment of Stable Terrible Triad Elbow Injuries After Closed Reduction: A Systematic Review

Saidil Mursalin

doi:10.55927/eajmr.v5i6.201

Authors

Saidil Mursalin Universitas Abulyatama Aceh

DOI:

https://doi.org/10.55927/eajmr.v5i6.201

Keywords:

Terrible triad elbow, conservative treatment, closed reduction

Abstract

Terrible triad injuries of the elbow have traditionally been treated surgically because of their association with instability, stiffness, and poor functional recovery. However, selected injuries that remain stable after closed reduction may be suitable for nonoperative treatment. This systematic review evaluated outcomes of nonoperative management in selected stable terrible triad injuries of the elbow. PubMed, Cochrane Library, and ScienceDirect were searched for studies reporting adult terrible triad injuries managed nonoperatively after closed reduction. Outcomes included elbow stability, delayed surgery, range of motion, functional scores, pain, complications, and post-traumatic arthritis. Functional outcomes were favorable, with reported mean MEPI/MEPS around 94–95 in several cohorts and excellent/good MEPS in 77% in the largest series. Delayed surgery occurred in up to 13% of patients, while complications included clicking, stiffness, heterotopic ossification, coronoid fibrous union or nonunion, and mild post-traumatic arthritis

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