{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:32:47Z","timestamp":1777498367996,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of this study was to describe the epidemiology, physiopathology, and outcomes of elbow \u201cunhappy triad\u201d trauma in children, combining a posterior dislocation, a proximal radius fracture, and a third lesion (i.e. bony or capsuloligamentous injury).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective bicentric study was conducted between 1999 and 2020. All skeletally immature children who presented to the emergency department and underwent surgery for a proximal radius injury were selected. Among this selection, only patients with two associated ipsilateral elbow injuries (i.e. posterior elbow dislocation and a bony and\/or capsuloligamentous injury) were included. Active elbow ranges of motion, Mayo Elbow Performance Score and Quick-Disabilities Of The Arm, Shoulder And Hand scores and standard radiographs were recorded at last follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-one patients met the inclusion criteria (mean age at surgery\u2009=\u200911.4\u2009years) among 737 selected. The \u201cunhappy triad\u201d diagnosis was made preoperatively in nine cases (bone lesion only), intraoperatively in nine cases, and postoperatively in one case. The third lesions were surgically treated when the lesion was a bony fracture or if the elbow remains unstable between 60\u00b0 and 90\u00b0 of flexion (i.e. capsuloligamentous injury). Twenty patients were reviewed (mean follow-up\u2009=\u20095.8\u2009years). The complications and re-operations rates were of 10%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The \u201cunhappy\u201d triad of the child\u2019s elbow is a rare injury, where the preoperative diagnosis is frequently missed and lead to 10% of complications and re-operations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18632521231211643","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T00:40:12Z","timestamp":1700181612000},"page":"581-589","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cUnhappy triad\u201d of the trauma elbow in children: Diagnosis, classification, and mid-term outcomes"],"prefix":"10.1177","volume":"17","author":[{"given":"Tristan","family":"Langlais","sequence":"first","affiliation":[{"name":"Department of Pediatric Orthopedics, Purpan Children Hospital, Toulouse University, Toulouse, France"},{"name":"Department of Pediatric Orthopedics, Necker Hospital, Paris Cit\u00e9 University, Paris, France"},{"name":"Department of Pediatric Orthopedics, Armand-Trousseau Hospital, Sorbonne University, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Louis","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Armand-Trousseau Hospital, Sorbonne University, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Badina","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Necker Hospital, Paris Cit\u00e9 University, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Vialle","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Armand-Trousseau Hospital, Sorbonne University, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phanie","family":"Pannier","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Necker Hospital, Paris Cit\u00e9 University, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malo","family":"Le Hanneur","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Armand-Trousseau Hospital, Sorbonne University, Paris, France"},{"name":"Hand to Shoulder Mediterranean Center, ELSAN, Clinique Bouchard, Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franck","family":"Fitoussi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Armand-Trousseau Hospital, Sorbonne University, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"key":"bibr1-18632521231211643","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(41)90207-6"},{"key":"bibr2-18632521231211643","doi-asserted-by":"publisher","DOI":"10.3109\/17453678608994398"},{"issue":"2","key":"bibr3-18632521231211643","first-page":"232","volume":"13","author":"D\u2019souza S","year":"1993","journal-title":"J Pediatr Orthop"},{"key":"bibr4-18632521231211643","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199507000-00002"},{"issue":"2","key":"bibr5-18632521231211643","first-page":"145","volume":"109","author":"Gartland JJ.","year":"1959","journal-title":"Surg Gynecol 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