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- Title
Using an Internal Joint Stabilizer Through a Single Posterior Approach for Elderly Patients With Terrible Triad Injury.
- Authors
Chiu, Yen-Chun; Wu, Chin-Hsien; Tsai, Kun-Ling; Jou, I-Ming; Tu, Yuan-Kun; Ma, Ching-Hou
- Abstract
Introduction: Treating a terrible triad injury of the elbow remains a challenge for orthopedic surgeons, especially in elderly patients due to the poor quality of the surrounding soft tissue and bony structures. In the present study, we propose a treatment protocol using an internal joint stabilizer through a single posterior approach and analyze the clinical results. Materials and Methods: We retrospectively reviewed 15 elderly patients with terrible triad injuries of the elbow who underwent our treatment protocol from January 2015 to December 2020. The surgery involved a posterior approach, identification of the ulnar nerve, bone and ligament reconstruction, and the application of the internal joint stabilizer. A rehabilitation program was initiated immediately after the operation. Surgery-related complications, elbow range of motion (ROM), and functional outcomes were evaluated. Results: The mean follow-up period was 21.7 months (range, 16-36 months). ROM at the final follow-up was 130° in extension to flexion and 164° in pronation to supination. The mean Mayo Elbow Performance Score was 94 at the final follow-up. Major complications included breaking of the internal joint stabilizer in 2 patients, transient numbness over the ulnar nerve territory in one, and local infection due to irritation of the internal joint stabilizer in one. Conclusions: Although the current study involved only a small number of patients and the protocol comprised two stages of operation, we believe that such a technique may be a valuable alternative for the treatment of these difficult cases. Level of Clinical Evidence: 4.
- Subjects
INTERNAL fixation in fractures; PATIENT aftercare; RANGE of motion of joints; ELBOW dislocation; JOINT instability; ULNA injuries; GERIATRIC assessment; RETROSPECTIVE studies; POSTOPERATIVE care; INFORMED consent (Medical law); MEDICAL protocols; FRACTURE fixation; RESEARCH funding; ELBOW fractures; COMPUTED tomography; BONE fractures; KINEMATICS; OLD age
- Publication
Geriatric Orthopaedic Surgery & Rehabilitation, 2023, p1
- ISSN
2151-4585
- Publication type
Article
- DOI
10.1177/21514593231162193