) Terrible triad injury of the elbow is a complex injury that is classically defined as elbow dislocation along with fractures of the coronoid process of the ulna and the radial head. The injury is usually associated with typical soft-tissue disruptions (with common involvement of the lateral collateral ligament complex, elbow joint capsule, as well as the common extensor and flexor-pronator tendons)(2).

Complications of terrible triad injuries include redislocation, residual instability, elbow stiffness, heterotopic ossification, fracture malunion or nonunion, elbow arthrosis, olecranon bursitis, ulnar or radial nerve palsy (due to the surgical approach or placement of hardware), and hardware related complications(2) .

Management of trrible triade is conservative or surgical treatment ,in this study we will use surgical treatment and make evaluation of it.

The elbow is the second most commonly dislocated joint in adults and up to 20% of dislocations are associated with a fracture. (1) Terrible triad injury of the elbow is a complex injury that is classically defined as elbow dislocation along with fractures of the coronoid process of the ulna and the radial head. The injury is usually associated with typical soft-tissue disruptions (with common involvement of the lateral collateral ligament complex, elbow joint capsule, as well as the common extensor and flexor-pronator tendons) Complications of terrible triad injuries include redislocation, residual instability, elbow stiffness, heterotopic ossification, fracture malunion or nonunion, elbow arthrosis, olecranon bursitis, ulnar or radial nerve palsy (due to the surgical approach or placement of hardware), and hardware related complications.

Management of trrible triade is conservative or surgical treatment ,in this study we will use surgical treatment and make evaluation of it.

Surgical treatment involves radial head repair or replacement ,medial and lateral collateral ligament repair and coronoid fracture fixation.

aim of research isFunctional assessment of surgical treatment of terrible triade injury of the elbow according to Mayo elbow performance score, According to the system of Mayo, scores of 90-100 are classified as excellent, 75-89 as good, 60-74 as fair, and 0-59 as poor

Inclusion Criteria:

• 1.skeletally mature patients (over 17 years old) including both sexes. 2.Acute fractures within 3 weeks of injury. 3.Isolated & closed fractures . 4.polytrauma trauma patients with no other injuries in the same limb.

Exclusion Criteria:

• 1. pathological fracture of proximal radius and ulna. 2. deteriorateed general health. 3. previous history of dysfunction with the affected elbow.

clinical case series study .