A rare injury of terrible triad of elbow with ipsilateral wrist fracture - is minimal intervention enough?

• Author Details:   
• Mayuresh Sambhaji Dhane ^*
• Muniramaiah Ravishankar

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The combination of an ipsilateral "terrible triad" injury of the elbow—comprising elbow dislocation, radial head fracture, and coronoid process fracture—with a distal end radius fracture is exceedingly rare. Such a presentation poses significant challenges in diagnosis, surgical planning, and rehabilitation. We report the case of a 50-year-old woman who sustained ipsilateral terrible triad injury of the elbow and distal end radius fracture following a fall from a ladder, landing on her outstretched hand. Radiographic evaluation also revealed a complex injury pattern. The patient underwent closed reduction and internal fixation using K-wire for both the elbow and wrist along with additional ligamento-taxis using external fixator for the wrist injuries. With a stable joint and active range of motion, the patient demonstrated a satisfactory functional improvement following an uncomplicated postoperative recovery. This case emphasizes the potential of K-wire fixation as a viable and minimally invasive method as an alternative in managing such a complex upper limb injuries.

Keywords: Radial head fracture, Coronoid process fracture, Elbow fracture-dislocation, K-wire.