Evidence map›Paper›PMID 40177659›Full record

ArticleTrauma case reports2025

Elbow terrible triad: Advancing current concepts in the treatment of 13 cases.

Edgar Barros Prieto, Eduardo Noboa, Carlos Ballesteros, Carlos Peñaherrera, Francisco Endara, Alejandro Barros Castro

Abstract readCase Reports
In one paragraph

Article in Trauma case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Which is the optimal surgical strategy for the terrible triad of the elbow?Journal of orthopaedic surgery and research · 2026
    Pooled it
  2. Surgical strategies for coronoid fixation in terrible triad elbow injuries: A comparative analysis of Tight-Rope and screw fixation.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Edgar Barros PrietoDepartment of Orthopedics and Traumatology, Hospital Voz Andes, Quito, Ecuador.
Eduardo NoboaDepartment of Orthopedics and Traumatology, Hospital Voz Andes, Quito, Ecuador.
Carlos BallesterosDepartment of Orthopedics and Traumatology, Hospital Metropolitano, Quito, Ecuador.
Carlos PeñaherreraDepartment of Orthopedics and Traumatology, Hospital Voz Andes, Quito, Ecuador.
Francisco EndaraInternational University of Ecuador in the Metropolitan Hospital, Quito, Ecuador.
Alejandro Barros CastroInternational University of Ecuador in the Metropolitan Hospital, Quito, Ecuador.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The "terrible triad" of the elbow is characterized by a combination of elbow dislocation with fractures of the radial head and the coronoid process of the ulna. This injury is notoriously complex due to the rupture of key elements that ensure elbow stability, resulting in poorer outcomes compared to simpler joint injuries. Despite advances in treatment protocols, an optimal surgical approach and fixation technique standard have not yet been established. Methods: This descriptive study focused on reviewing the anatomical and clinical characteristics of the elbow joint, considering the most current biomechanical concepts. Management protocols implemented in our practice were evaluated, including specific surgical techniques and fixation methods based on a deep understanding of elbow anatomy and biomechanics. Retrospective data were collected from patients treated at our centers, analyzing postoperative clinical and radiographic outcomes. Results: The implementation of a treatment based on updated concepts of elbow biomechanics and anatomy showed a significant improvement in postoperative joint stability and functional recovery of patients. There was a reduction in complication rates and an improvement in clinical outcomes compared to traditional approaches. The selection of specific fixation techniques and surgical approaches allowed for more effective management of the "terrible triad," adapting to the particularities of each case and optimizing results. Conclusion: This study highlights the importance of a detailed understanding of elbow biomechanics and anatomy for the effective management of the "terrible triad." The implementation of protocols based on these principles can significantly improve clinical outcomes and reduce complications, offering a comprehensive approach to addressing this complex pathology.Level of Evidence: IV.

Indexed as

Coronoid processElbowElbow approachesFracture and dislocationTerrible-triad injuryTraumaTreatment protocol

Identifiers

PMID40177659
PMCPMC11964649

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.