Objective: Terrible triad elbow ınjury (TTEI) is a complex trauma characterised by posterolateral dislocation, radial head fracture, and coronoid process fracture. Such injuries can lead to elbow instability and loss of function. The role of anterior capsulodesis surgery in the treatment of TTEI has not been fully established. The aim of this study was to evaluate the efficacy of anterior capsulodesis in patients with TTEI, to see its effect on elbow functional scores, to analyze possible post-operative complications, and to compare them with the literature.
Materials and
Methods: This retrospective study analyzed 14 patients diagnosed with TTEI between 2017 and 2022. Patients with O’Driscoll type I-II and Regan–Morrey type I-II fractures were treated with a treatment protocol that included radial head fixation, lateral collateral ligament repair, and transosseous anterior capsulodesis. The mean follow-up was 23.2 months. Surgical outcomes were assessed using the Mayo Elbow Performance Score, Disabilities of the Arm, Shoulder, and Hand, and Broberg–Morrey classification.

Results: This study suggests that endobutton fixation of O’Driscoll and Regan–Morrey type I-II coronoid fractures in the treatment of TTEI has a positive effect on elbow function in the medium and long term. In particular, for fractures with limited coronoid involvement and capsular avulsion, anterior capsulodesis has been shown to improve functional outcomes and reduce the incidence of post-traumatic osteoarthritis.

Conclusion: Anterior capsulodesis is an effective option for the treatment of TTEI in terms of improving elbow function and reducing complications. When we reviewed the available studies in the literature, we concluded that anterior capsulodesis is a valuable procedure in the treatment of TTEI.