The "terrible triad" of the elbow is a rare traumatic injury that must be managed properly for an adequate functional outcome.

Elements of the terrible triad:

(1) fracture of the radial head

(2) fracture of the coronoid process

(3) elbow dislocation


Variants exist based on

(1) the different types of fracture that can occur.

(2) other traumatic injuries present


Risk factors:

(1) male gender

(2) high energy trauma

(3) fall onto an outstretched hand with elbow in hyperextension, supination and valgus stress


Surgery is the usual method of management. Conservative therapy can result in significant complications.



(1) ulnar nerve palsy

(2) arthritis

(3) dystrophic calcification

(4) decreased range of motion

To read more or access our algorithms and calculators, please log in or register.