Surgical treatment of terrible triad of the elbow

Terrible triad of the elbow associates posterior dislocation, radial head fracture and coronoid process fracture. It is a complex trauma, associating severe bone ligament lesions, with high more-or-less long-term risk residual instability, stiffness, pain osteoarthritis. During last 20 years, pathologic, biomechanical clinical knowledge has greatly progressed. Prevention these complications requires initial understanding lesion mechanism precise analysis all lesions. Surgery aims to restore perfect stability by sequential anatomic repair, enabling early mobilization prevent onset stiffness. The present paper were summarize pathophysiological bases, highlight crucial importance humeroradial column lateral collateral ligament, determine process. Some aspects treatment are controversial: systematic medial or use an articulated external fixator. Finally, we propose simple algorithm guide repair.