Long-term functional outcomes of the terrible triad of the elbow

Abstract

Introduction: The published literature regarding the terrible triad of the elbow has historically shown a high rate of unacceptable outcomes. The objective of the present study was to evaluate the long-term functional outcomes and repercussions in patients who suffered the terrible triad of the elbow. Material and methods: A retrospective analysis of a prospectively-recruited consecutive series of cases registered from August 2005 to August 2009, involving 27 patients from which 16 complied with inclusion criteria for the study. The mean follow-up period was 8.6 years (range: 6.9 to 10.6). Two different final quality of life evaluation questionnaires were performed by telephone: the EuroQol Five Dimensions Questionnaire (EQ-5D) and the patient answered questionnaire portion of the Liverpool Elbow Score (PAQ-LES). Results: Fifteen (93.7%) patients were intervened surgically whereas only 1 case was treated conservatively. EQ-5D-rated outcome averaged 0.87 (range: 0.36 to 1) and the PAQ-LES averaged 33.5 (range: 17 to 36). Five (31.2%) presented pain or discomfort, 4 (25.0%) had some kind of difficulties in their daily activity and 3 (18.7%) founded some limitations with their personal hygiene. Only 6 cases (37.5%) declared to be fully asymptomatic. Conclusion: The terrible triad of the elbow remains a challenging injury that entails the presence of chronic pain and discomfort in almost one third of the cases at a long-term follow-up.