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09 July 2018 : Clinical Research  

Does Timing of Surgery Affect Treatment of the Terrible Triad of the Elbow?

Chengwei Zhou1EF, Jinti Lin1B, Jianxiang Xu1C, Renjin Lin1CF, Kai Chen1D, Shuaibo Sun1F, Jianzhong Kong1A*, Xiaolong Shui1A

DOI: 10.12659/MSM.907146

Med Sci Monit 2018; 24: CLR4745-4752

Abstract

BACKGROUND: This study investigated the influence of surgical timing on the treatment of terrible triad of the elbow (TTE).

MATERIAL AND METHODS: After exclusion, 63 patients were enrolled in this study: 20 patients were classified into the emergency group (group A, within 24 h after injury), 26 into the early surgery group (group B, from 4 to 14 days after injury), and 17 into the delayed surgery group (group C, more than 14 days after injury). All patients underwent the same approach, and elbow motion and complication rates were recorded and compared.

RESULTS: Fifty-eight patients were followed up (mean 20.5±1.9 months), and 5 patients had lost partial final data. At 1 month after the operation, elbow motion in group A was higher than in group B and group C (P<0.01); however, 3 or more months later, there was no distinct difference between group A and group B (P>0.05), while both group A and group B showed better outcomes than group C at all time points (P<0.05). Moreover, group A and group B had better higher elbow motion, MEPS, excellent and good rate than group C at the final clinical visit (all P<0.05). No postoperative pain or complication rate differences were found among the 3 groups except for elbow stiffness (2 in group A, 3 in group B, and 7 in group C) (P<0.05) which required reoperation to enhance elbow function.

CONCLUSIONS: Emergency or early operation for TTE patients were more effective than delayed operation.

Keywords: Anastomosis, Surgical, Elbow, Recovery of Function

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750