Management of Ipsilateral Terrible Triad Injury of Elbow and Concomitant Proximal Humerus Fracture: A Case Report and Literature Review

J Orthop Case Rep. 2024 Mar;14(3):109-113. doi: 10.13107/jocr.2024.v14.i03.4308.

Abstract

Introduction: A difficult pattern of injuries is Hotchkiss's terrible triad, which includes elbow dislocations with fracture of the coronoid and head of radius. It is uncommon to have a concurrent proximal humerus fracture, which makes clinical care even more difficult.

Case report: An injured worker, 33 years old, claimed to have fallen from a height and received several injuries when he arrived at our emergency center. On physical examination, the patient showed signs of deformity and had an open injury over his left elbow. The radiographic evaluation showed that the patient had a posterior elbow dislocation along with a fracture of the left coronoid, head of radius, and proximal humerus. Following the reduction in a closed manner, computed tomography of the left elbow was carried out for additional assessment. The patient had both the proximal humerus and elbow fixed, and then the elbow was immobilized for 2 weeks.

Conclusion: Complex musculoskeletal injuries resulting from high-energy trauma require a thorough, multidisciplinary strategy to address since long-term results and any consequences will require ongoing monitoring and rehabilitation.

Keywords: Lateral collateral ligament; multidisciplinary approach; proximal humerus fracture; terrible triad.

Publication types

  • Case Reports