More Anteromedial Coronoid Involvement in Combined Fractures of the Coronoid and Radial Head Than Traditional Teaching

The terrible triad injury involves an ulnohumeral dislocation, radial head fracture, and coronoid process fracture. According to traditional teaching, these injuries are strongly associated with anterolateral coronoid tip fractures and can be addressed via a lateral approach to the elbow. However, recent small clinical series suggest that some terrible triad injuries have larger coronoid fractures involving the anteromedial facet. It is important to understand how often these larger coronoid fractures occur because anteromedial facet fractures may need a different approach and different implants for fixation. An improved understanding of coronoid fracture morphology in terrible triad injuries may help surgeons construct a surgical plan.