Coronal process fracture and radial head fracture are accompanied by posterior dislocation of the elbow joint, which is called the "terror triad" by Hotchkiss. It consists of the elbow fracture and the medial and lateral collateral ligament injuries of the elbow joint, resulting in severe instability, which is very difficult in clinical treatment as one of the main factors affecting the stability of the elbow joint, coronal process fracture plays a pivotal role in preventing posterior dislocation of the elbow joint. There is no adequate internal fixation for the coronal process fracture fragment with conventional methods, so it has always been a difficult point in clinical treatment. The technique of suture lasso was used in the cases of coronal process fracture of Regan-Morrey type I/II, and the preliminary curative effect was obtained. Objective To explore the operative method and clinical effect of the suture lasso technique in treating Regan-Morrey type I/II coronal process fracture.

From January 2018 to June 2022, the clinical data and follow-up results of 18 patients with coronal process Regan-Morrey type I/II fracture in terror triad of the elbow treated with suture lasso technique were retrospectively analyzed, including 12 males and 6 females. Their ages ranged from 18 to 55 years, with an average age of 32 years. The causes of injuries included 12 cases of traffic injuries, 5 cases of high fall injuries, and 1 case of fall damage. All of them were type I/II according to the Regan-Morrey classification. All the lateral collateral ligaments were injured. All patients were treated through a lateral approach to reduce and fix fractures of the coronal process, radial head, and lateral collateral ligament. After the operation, the elbow joint was set in the functional position for 2 weeks, followed by functional exercise. The outpatients were followed up regularly for 3 weeks, 6 weeks, and 3 months after the operation. The postoperative elbow joint score was evaluated by the MEPS score system.

All patients were followed up for 3 to 52 months, with an average of 18 months. Bone union was achieved in all fractures. Elbow joint flexion position (0-30°), extension position (90-125°), with an average range of joint motion being 103.61°; pronation (10-90°), supination (20-90o), with an average rotation range of 142.78°. According to the MEPS Elbow Performance Index, the average postoperative score was 88.89 points (range 65-100 points). Among them, 12 cases were excellent, 3 were good, and 3 were moderate. The excellent and good rate was 83.3%. Three patients developed myositis ossificans. One patient took out the suture anchor due to infection.

In the terror triad of the elbow, the clinical effect of the lateral approach of the elbow joint using the suture lasso technique to fix the coronal process fracture of Regan-Morrey I/ II type fracture is satisfactory.