Terrible Triad Surgery and Radial Head Replacement
Overview
A terrible triad injury is a complex elbow fracture-dislocation involving the radial head, coronoid and ligament stabilisers. These injuries make the elbow unstable and can lead to stiffness, recurrent instability and arthritis if not treated appropriately.
Treatment may involve radial head fixation or replacement, coronoid fracture management and repair or reconstruction of the lateral ligament, with medial ligament stabilisation added when required.
Who may benefit from surgery?
Most terrible triad injuries require surgery because the elbow is unstable. Radial head fixation may be suitable when the fracture fragments can be reconstructed. Radial head replacement is considered when the radial head is too damaged to repair reliably.
What does the procedure involve?
The radial head is either fixed with screws or replaced with a prosthesis. The lateral ligament complex is repaired or reconstructed to restore stability. If the elbow remains unstable, the medial ligament may also be repaired or reconstructed. Associated coronoid injury is treated according to size and stability.
Recovery after terrible triad surgery
The elbow is prone to stiffness, so early controlled movement is important. At the same time, the repaired ligaments and fractures need protection. Rehabilitation is therefore carefully structured.
Rehabilitation protocol
You will receive a protocol for terrible triad surgery, radial head replacement or radial head ORIF depending on the procedure performed.
FAQs
What makes a terrible triad injury serious?
It combines fracture and ligament injury, creating a highly unstable elbow.
When is radial head replacement needed?
It is used when the radial head fracture cannot be reconstructed reliably.
Will I need ligament repair?
Usually yes. Lateral ligament repair is common, with medial stabilisation added if needed.
Will my elbow become stiff?
Stiffness is common after these injuries. Early guided motion is important.
How long does recovery take?
Functional recovery takes months and depends on injury severity and stability.
Book or Refer Today
For complex elbow fracture-dislocation or radial head fracture, book an assessment to review fixation and replacement options.
Reconstructive Orthopaedics Melbourne (ROM)
We restore mobility, reduce pain, and improve quality of life — through reconstructive orthopaedic surgery driven by evidence and advanced biomechanics.