Fractures of the radial head and coronoid process, and disruption of the lateral collateral ligament (LCL),  constitute the so-called "terrible triad"injury.
                                                                                           

Treatment always requires restoration of an intact LCL and radial head; small fractures of the coronoid may be treated conservatively, but intraoperative assessment of stability in extension is critical. Larger fractures require repair, however, since the coronoid provides restraint to varus stress, and provides a butress to resist subluxation in extension.If the radial head cannot be fixed, replacement will be required.
                                                                                       

This treatment approach can restore a stable elbow with satisfactory functional outcome.

                     

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