Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Původní práce / Original papers

85, 2018, p. 102 - 108

Použití "mother-child" šroubů v léčení zlomenin processus coronoideus u  nešťastné triády loketního kloubu

Use of Mother-Child Screws in the Treatment of Coronoid Fractures in Terrible Triad Injury of the Elbow

Y. SHI1, G.-F. WANG1, K. MEI1, J. ZHANG1, C.-J.YUN1, C. QIAN1, J.-Y. SUN2
1 Department of Orthopaedic Surgery, The Affiliated Wujin Hospital of Jiangsu University, Changzhou, China
2 Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China



This study aims to analyze the clinical and radiographic outcomes of a  consecutive series of 18 patients with terrible triad injury. The coronoid fractures of these patients were repaired using Mother-Child screw (MCS).


Twelve men and six women (mean age: 47.2 years) with terrible triad injury of the elbow were followed up for a mean of 17.6 months (range: 13-42 months). Surgical treatment consisted of open reduction and internal fixation of coronoid fractures with MCS, radial head fracture with MCS (Mason type II, n = 10), or mini-plate (Mason type III, n = 3). Furthermore, all underwent lateral collateral ligament repair (n = 9, 100%), and in cases of persistent instability, medial collateral ligament repair was performed (n = 3, 33%).


At last follow-up, average arc of ulnohumeral motion was 130° (range: 65° to 150°), average arc of forearm rotation was 148° (range: 100°-160°), mean Disabilities of the Arm, Shoulder and Hand (DASH) score was 7.1 (range: 0-28.5), and mean Mayo Elbow Performance Score (MEPS) was 92 (range: 70-100). According to the Mayo Elbow Performance Index (MEPI), 10 patients were excellent in, seven patients were good, and one patient was fair. All patients had a stable elbow. No secondary coronoid fragment dislocation or implant failures was reported. Fracture healing was observed in all patients.


This study shows that coronoid fracture treatment with MCS may be a new, effective and easy therapeutic option in terrible triad injury.

Key words: terrible triad of the elbow, coronoid process, radial head, functional outcome

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