{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:19:33Z","timestamp":1764249573590,"version":"3.46.0"},"reference-count":15,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,6]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Complex elbow fracture-dislocations typically include ulnohumeral joint dislocation, radial head and coronoid process fractures and ligamentous disruption and are termed a terrible triad injury. In this case report, we describe a mid-60s female patient with a direct posterior elbow dislocation with comminuted radial head and coronoid process fractures combined with an olecranon avulsion fracture without ligamentous disruption. Surgical intervention was indicated to restore elbow stability and extensor mechanism via posterior approach to the elbow. Given radial head and coronoid fracture comminution, radial head arthroplasty was performed, and a radial head fragment was used as an autograft to reconstruct the coronoid process. Subsequently, the olecranon avulsion fracture was addressed via an all-suture repair through osseous tunnels. Surgical reconstruction resulted in a stable elbow without ligamentous repair and a restored extensor mechanism, and by 4\u2009months post-operatively, the patient had regained pain-free functional range of motion and returned to all her daily activities.<\/jats:p>","DOI":"10.1136\/bcr-2025-269099","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:15:29Z","timestamp":1764249329000},"page":"e269099","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Elbow fracture dislocation with associated olecranon avulsion fracture"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5021-2878","authenticated-orcid":false,"given":"Lilah","family":"Fones","sequence":"first","affiliation":[{"name":"Orthopaedic Surgery, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Liam","family":"Gibbons","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro K","family":"Beredjiklian","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Rothman Orthopaedic Institute at Jefferson, Philadelphia, Pennsylvania, USA"},{"name":"Orthopaedic Surgery, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory G","family":"Gallant","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Rothman Orthopaedic Institute at Jefferson, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"2025112705151908000_18.11.e269099.1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.5435\/JAAOS-D-14-00023","article-title":"Management of Complex Elbow Dislocations","volume":"23","author":"Wyrick","year":"2015","journal-title":"Journal of the American Academy of Orthopaedic Surgeons"},{"key":"2025112705151908000_18.11.e269099.2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200903000-00003"},{"key":"2025112705151908000_18.11.e269099.3","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1016\/j.jhsa.2015.04.039","article-title":"Terrible Triad Injuries of the Elbow","volume":"40","author":"Chen","year":"2015","journal-title":"J Hand Surg Am"},{"key":"2025112705151908000_18.11.e269099.4","first-page":"205","article-title":"Terrible triad of the elbow and associated variants: a systematic review","volume":"2","author":"Medina","year":"2022","journal-title":"JSES Rev Rep Tech"},{"key":"2025112705151908000_18.11.e269099.5","doi-asserted-by":"crossref","first-page":"266","DOI":"10.5435\/00124635-200007000-00007","article-title":"Olecranon fractures: treatment options","volume":"8","author":"Hak","year":"2000","journal-title":"J Am Acad Orthop Surg"},{"key":"2025112705151908000_18.11.e269099.6","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.CC.20.00308","article-title":"Terrible Triad Elbow Fracture Dislocation with Ipsilateral Triceps Avulsion and Radial Shaft Fracture: A Case Report","volume":"10","author":"Dehghani Nazhvani","year":"2020","journal-title":"JBJS Case Connect"},{"key":"2025112705151908000_18.11.e269099.7","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.jhsa.2010.12.027","article-title":"Elbow Fracture\u2013Dislocation With Triceps Avulsion: Report of 2 Cases","volume":"36","author":"Lambers","year":"2011","journal-title":"J Hand Surg Am"},{"key":"2025112705151908000_18.11.e269099.8","doi-asserted-by":"crossref","first-page":"e982","DOI":"10.5435\/JAAOS-D-24-00310","article-title":"Management of Elbow Terrible Triad Injuries: A Comprehensive Review and Update","volume":"32","author":"Fahs","year":"2024","journal-title":"J Am Acad Orthop Surg"},{"key":"2025112705151908000_18.11.e269099.9","doi-asserted-by":"crossref","first-page":"519","DOI":"10.5435\/00124635-200808000-00013","article-title":"Coronoid process fracture","volume":"16","author":"Steinmann","year":"2008","journal-title":"J Am Acad Orthop Surg"},{"key":"2025112705151908000_18.11.e269099.10","doi-asserted-by":"crossref","first-page":"11656","DOI":"10.1038\/s41598-023-38885-1","article-title":"A novel and superior Lasso-plate technique in treatment for coronoid process fracture in the terrible triad of elbow","volume":"13","author":"Wang","year":"2023","journal-title":"Sci Rep"},{"key":"2025112705151908000_18.11.e269099.11","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/j.jse.2022.12.024","article-title":"Superior fixation strength of coronoid process replacement using individually designed 3D printed prosthesis with curved cemented intramedullary stem","volume":"32","author":"Pukalski","year":"2023","journal-title":"J Shoulder Elbow Surg"},{"key":"2025112705151908000_18.11.e269099.12","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1097\/BOT.0000000000000326","article-title":"Coronoid Fractures","volume":"29","author":"Ring","year":"2015","journal-title":"J Orthop Trauma"},{"key":"2025112705151908000_18.11.e269099.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2011.12.016"},{"key":"2025112705151908000_18.11.e269099.14","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jhsa.2018.08.001","article-title":"Management of the Posttraumatic Coronoid-Deficient Elbow","volume":"44","author":"Bellato","year":"2019","journal-title":"J Hand Surg Am"},{"key":"2025112705151908000_18.11.e269099.15","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.2106\/00004623-200310000-00015","article-title":"Surgical treatment of distal triceps ruptures","volume":"85","author":"van Riet","year":"2003","journal-title":"J Bone Joint Surg Am"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269099","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:15:31Z","timestamp":1764249331000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":15,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,27]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bcr-2025-269099"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269099","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}