2020 April Fools' Case: Normally we'd prank you with this but given the current COVID-19 crisis we decided just to release it straight up without trying to trick anyone. Hopefully you can at least still enjoy a little laugh at this difficult time - view case

Elbow fracture-dislocation - terrible triad

Case contributed by Dr Henry Knipe


Football injury - unable to straighten arm.

Patient Data

Age: 30 years
Gender: Male


Elbow dislocation with posterolateral displacement of the proximal radius and ulna. Intra-articular radial head fracture. Bone chip projects inferiorly to the distal humerus - unclear origin. Large joint effusion. 

Elbow dislocation was reduced under propofol sedation. 

Comminuted and displaced fracture of the radial head with the distal humerus impacting and separating the distal fracture fragment, which lies posteriorly to the distal humerus and results in anterior subluxation of the elbow joint. Undisplaced chip fracture through the medial ulna at its articulation with the proximal radius. Small displaced fracture of the coronoid process. No humeral fracture imaged. Joint effusion with small locule of gas noted. 

Case Discussion

This injury is called the terrible triad of the elbow - posterior elbow dislocation, coronoid process fracture and radial head fracture - due to often poor outcomes. 

PlayAdd to Share

Case information

rID: 27791
Published: 21st Feb 2014
Last edited: 12th Oct 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.