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Review Question - QID 192

QID 192 (Type "192" in App Search)
A 35-year-old woman presents with an elbow injury which includes a coronoid fracture involving more than 50%, a comminuted radial head fracture, and an elbow dislocation. What is the most appropriate treatment?

closed reduction and early range of motion

1%

14/2083

radial head resection and lateral collateral ligament reconstruction

1%

11/2083

radial head resection and coronoid open reduction internal fixation

2%

42/2083

radial head arthroplasty and coronoid open reduction internal fixation

8%

162/2083

radial head arthroplasty, coronoid open reduction internal fixation, and lateral collateral ligament repair

88%

1836/2083

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A terrible triad of the elbow includes dislocation of the elbow with associated fractures of the radial head and the coronoid process. Ring et al. stressed that these injuries are prone to complications and advised against resection of the radial head due to instability, and instead recommended a radial head replacement if too comminuted for ORIF. Coronoid fractures compromise elbow stability as well and require open reduction and internal fixation as with the lateral collateral ligament. McKee et al. showed stable elbows in 34/36 with mean Mayo elbow score of 88 when the standard protocol of coronoid ORIF, radial head repair/replacement, and LCL repair were employed.

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