Abstract：
BACKGROUND: Surgical techniques for Terrible Triad injuries developed 20 years ago. Good and excellent short- and medium-term functional results have been reported. No long-term (over 10 years) functional outcomes have previously been reported. This case-series is the longest follow-up of patients treated for acute, isolated terrible triad injuries using a standard treatment protocol.
METHODS: 20 Patients with acute, isolated, surgically managed terrible triad injuries were treated between October 2001 and May 2008. 10 of these patients were seen face-to face for a clinical follow-up and if required a radiological assessment. Mayo Elbow Performance Scores (MEPS) and Disability of the Arm, Shoulder and Hand (DASH) scores, requirement for further surgery and elbow instability were recorded.
RESULTS: The average length of follow-up was 18.8 years. The mean MEPS was 88 and the mean DASH score was 12.3. The average loss of pronation was 8 degrees. The average loss of supination was 13 degrees. The re-operation rate was 40%, only one of these was a functionally limiting operation. A trend towards osteoarthritis was observed but there were no conversions to total elbow replacement.
CONCLUSIONS: This is the longest-term follow-up study of these injuries and demonstrates the functional performance that the majority of patients achieve. The low follow-up rate can be expected with such a long interval between treatment and assessment. A relatively high re-operation rate is largely made up of minor procedures (removal of metalwork and cubital tunnel release) which did not impact the patients\' functional status.
CONCLUSIONS: This study adds to the evidence that the terrible triad of the elbow is surgically treatable to allow a high functional standard not only in the short-term but also in the long-term. As such this is a useful adjunct to have both when informing patients of what can be expected in their long-term recovery from this injury.
METHODS: 20 Patients with acute, isolated, surgically managed terrible triad injuries were treated between October 2001 and May 2008. 10 of these patients were seen face-to face for a clinical follow-up and if required a radiological assessment. Mayo Elbow Performance Scores (MEPS) and Disability of the Arm, Shoulder and Hand (DASH) scores, requirement for further surgery and elbow instability were recorded.
RESULTS: The average length of follow-up was 18.8 years. The mean MEPS was 88 and the mean DASH score was 12.3. The average loss of pronation was 8 degrees. The average loss of supination was 13 degrees. The re-operation rate was 40%, only one of these was a functionally limiting operation. A trend towards osteoarthritis was observed but there were no conversions to total elbow replacement.
CONCLUSIONS: This is the longest-term follow-up study of these injuries and demonstrates the functional performance that the majority of patients achieve. The low follow-up rate can be expected with such a long interval between treatment and assessment. A relatively high re-operation rate is largely made up of minor procedures (removal of metalwork and cubital tunnel release) which did not impact the patients\' functional status.
CONCLUSIONS: This study adds to the evidence that the terrible triad of the elbow is surgically treatable to allow a high functional standard not only in the short-term but also in the long-term. As such this is a useful adjunct to have both when informing patients of what can be expected in their long-term recovery from this injury.
摘要：
背景：可怕的三合会损伤的手术技术在20年前发展起来。报告了良好和优异的短期和中期功能结果。以前没有长期（超过10年）功能结果的报道。该病例系列是对急性，孤立的可怕的三合会伤害使用标准的治疗方案。
方法：20例急性，孤立的,在2001年10月至2008年5月期间，经过手术处理的可怕的三合会受伤得到了治疗。这些患者中有10人面对面进行临床随访，如果需要进行放射学评估。梅奥肘部成绩（MEPS）和手臂残疾，肩和手（DASH）得分，记录了进一步手术的需求和肘部不稳定。
结果：平均随访时间为18.8年。平均MEPS为88，平均DASH评分为12.3。内旋的平均损失为8度。旋后的平均损失为13度。再次手术率为40%,其中只有一个是功能限制操作。观察到骨关节炎的趋势，但没有转换为全肘关节置换。
结论：这是对这些损伤的最长期的随访研究，并证明了大多数患者的功能表现。在治疗和评估之间如此长的间隔下，可以预期低随访率。相对较高的再次手术率主要由次要程序（去除金属制品和肘管释放）组成，这些程序不会影响患者的功能状态。
结论：这项研究增加了证据，证明肘部可怕的三联征可以通过手术治疗，不仅在短期而且在长期内都可以达到较高的功能标准。因此，当告知患者从这种损伤中长期恢复时，这是一个有用的辅助手段。
方法：20例急性，孤立的,在2001年10月至2008年5月期间，经过手术处理的可怕的三合会受伤得到了治疗。这些患者中有10人面对面进行临床随访，如果需要进行放射学评估。梅奥肘部成绩（MEPS）和手臂残疾，肩和手（DASH）得分，记录了进一步手术的需求和肘部不稳定。
结果：平均随访时间为18.8年。平均MEPS为88，平均DASH评分为12.3。内旋的平均损失为8度。旋后的平均损失为13度。再次手术率为40%,其中只有一个是功能限制操作。观察到骨关节炎的趋势，但没有转换为全肘关节置换。
结论：这是对这些损伤的最长期的随访研究，并证明了大多数患者的功能表现。在治疗和评估之间如此长的间隔下，可以预期低随访率。相对较高的再次手术率主要由次要程序（去除金属制品和肘管释放）组成，这些程序不会影响患者的功能状态。
结论：这项研究增加了证据，证明肘部可怕的三联征可以通过手术治疗，不仅在短期而且在长期内都可以达到较高的功能标准。因此，当告知患者从这种损伤中长期恢复时，这是一个有用的辅助手段。
