{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T03:00:19Z","timestamp":1772247619159,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T00:00:00Z","timestamp":1613952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011710","name":"Shaanxi Provincial Science and Technology Department","doi-asserted-by":"publisher","award":["2017SF\u2010197"],"award-info":[{"award-number":["2017SF\u2010197"]}],"id":[{"id":"10.13039\/501100011710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze the risk factors of elbow stiffness following open reduction and internal fixation of the terrible triad of the elbow joint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted of 100 patients with the terrible triad of the elbow joint, who had been treated at our hospital from January 2015 to December 2018. All patients were treated with a loop plate to repair the ulnar coronoid process. According to the severity of the injury, the radial head was either fixed or replaced, and the lateral collateral ligament was repaired with an anchor. According to the range of motion of the elbow during the last follow\u2010up, the patients were divided into two groups. The stiffness group (displayed extension\u2013flexion or pronation\u2013supination &lt;100\u00b0) consisted of 30 patients. The second group, named the non\u2010stiffness group (exhibited extension\u2013flexion and pronation\u2013supination \u2265100\u00b0), consisted of 70 patients. Related risk factors included age, gender, smoking, diabetes, whether the fracture is on the dominant side, mechanism of injury, fracture classification, time from injury to surgery, configuration of internal fixation of the radial head, postoperative immobilization time, and use of anti\u2010heterotopic ossification drugs (oral indomethacin). Both <jats:italic>t<\/jats:italic>\u2010test and chi squared test were used to analyze any significant differences. Only the variables with a <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 in the tests were retested into a logistic multiple regression in order to screen risk factors of elbow stiffness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were followed up for 12\u201348\u2009months (average, 25.7\u2009months), and all patients exhibited bone healing. Multivariate regression analysis showed that high\u2010energy injury (OR = 3.068, 95% CI 1.134\u20138.295, <jats:italic>P<\/jats:italic> = 0.027), time from injury to surgery\u2009&gt;\u20091\u2009week (OR = 2.714, 95% CI 1.029\u20137.159, <jats:italic>P<\/jats:italic> = 0.044), and postoperative immobilization time (OR = 3.237, 95% CI 1.176\u20138.908, <jats:italic>P<\/jats:italic> = 0.023) were independent risk factors of elbow stiffness after surgery for the terrible triad of the elbow.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High\u2010energy injury, the time from injury to surgery\u2009&gt;\u20091\u2009week, and postoperative joint immobilization time\u2009&gt;\u20092\u2009weeks are the independent risk factors of elbow stiffness after surgery of the terrible triad of the elbow, which should be treated carefully in clinical treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12879","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T06:59:05Z","timestamp":1614063545000},"page":"530-536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Risk Factors of Elbow Stiffness After Open Reduction and Internal Fixation of the Terrible Triad of the Elbow Joint"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2607-9266","authenticated-orcid":false,"given":"Xiao","family":"He","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Hong Hui Hospital Xi'an Jiaotong University  Xi'an China"},{"name":"Yan'an University School of Medicine  Yan'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quan","family":"Fen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hong Hui Hospital Xi'an Jiaotong University  Xi'an China"},{"name":"Yan'an University School of Medicine  Yan'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiarui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hong Hui Hospital Xi'an Jiaotong University  Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutian","family":"Lei","sequence":"additional","affiliation":[{"name":"Xi'an Jiaotong University  Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisong","family":"Heng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hong Hui Hospital Xi'an Jiaotong University  Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hong Hui Hospital Xi'an Jiaotong University  Xi'an 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