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The
decision to perform or delay the operation in patients with terrible triad of
the elbow (TTE) is of utmost importance as emergency or early operation
resulted in improved functional recovery.
The terrible triad of the elbow can be managed in the better way if operated early or in the emergency, showed a recent study published in “Medical Science Monitor” Journal.
The TTE refers to the elbow dislocation which results in radial head and coronoid process fractures. The injury further can lead to complications like joint instability, pain or arthritis. Thus, Dr Chengwei Zhou and colleagues conducted a study to examine the therapy timing effect on the terrible triad of the elbow (TTE) treatment.
The study involved 63 patients, categorized into three groups. The group A was the emergency group (20 patients) who received therapy within 24h after injury. Group B was the early surgery group (26 patients) who got treatment within 4 to 14 days after injury. Group C was the delayed surgery group (17 patients) who received treatment 14 days after the injury. All groups went through the same treatment. The motion of the elbow and complexity rates were also compared and recorded.
Out of 63 patients, the follow up was done for 58 patients (mean 20.5±1.9 months). One month after the surgery, group A exhibited better elbow motion than group B and C (P<0.01). The group B (P>0.05) also showed better elbow motion as group A after 3 months and later. However, no better improvements were seen in group C (P<0.05). The elbow motion was noticed at the final clinical visit. In both groups, A and B, the MEPS (Mayo Elbow Performance score) was also high with better elbow movements as compared to group C (all P<0.05).
No major differences in postoperative complications were
observed among all 3 groups. The group A showed 2, B showed 3 and C showed 7
elbow stiffness cases. All these cases
required reoperation to improve elbow function. Further, the author concluded
that TTE should be operated as soon as possible to avoid the difficulty
circumstances in delayed treatment.
Med Sci Monit.
Does Timing of Surgery Affect Treatment of the Terrible Triad of the Elbow?
Chengwei Zhou et al.
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