Rehabilitation protocol
Elbow “Terrible Triad” Rehabilitation Protocol
The current rehabilitation used after surgical treatment of an elbow terrible-triad injury. Because these operations vary, your surgeon defines the safe arc of motion and how the elbow is loaded; early care protects a stable elbow while beginning protected motion to limit stiffness. Your surgical team will tailor it to you — always follow the individualized plan they give you.
Who this protocol is for
Applies to the rehabilitation of a surgically treated elbow terrible-triad fracture-dislocation (elbow dislocation with radial-head and coronoid fractures and the associated ligament injury). Terrible-triad operations vary from patient to patient, so the surgeon defines the stable arc of motion, forearm position, and loading, and the operative note governs. It does NOT apply to a simple elbow dislocation, an isolated radial-head fracture, an isolated coronoid fracture, a distal biceps repair, or an unrelated elbow operation. If a radial-head replacement is one component of the terrible-triad reconstruction and the surgeon selects this plan for the combined reconstruction, this plan governs. The operative note and surgeon-selected protocol take precedence, and patients should use only the protocol identified by their surgical team.
What this protocol covers
- Rehabilitation after surgical treatment of an elbow terrible-triad fracture-dislocation.
- These operations vary — your surgeon defines the stable arc of motion, forearm position, and loading, and the operative note governs.
- It does NOT apply to a simple elbow dislocation, an isolated radial-head or coronoid fracture, a distal biceps repair, or an unrelated elbow operation.
- If a radial-head replacement is part of the reconstruction and your surgeon selects this plan for the combined operation, this plan governs — use only the protocol you are given.
How this applies within a combined reconstruction
This protocol is for a surgically treated terrible-triad injury, in which the surgeon defines the safe arc of motion, forearm position, and loading. It is not the protocol for a simple elbow dislocation, an isolated radial-head or coronoid fracture, a distal biceps repair, or an unrelated elbow operation. When a radial-head replacement is one component of the terrible-triad reconstruction and your surgeon has selected this plan for the combined operation, this plan governs; a stand-alone radial-head replacement protocol applies only when specifically selected for an isolated replacement. This protocol never substitutes for your operative note or the plan your surgeon selected — follow the individualized instructions your surgical team gives you.
How rehabilitation is generally structured
Rehabilitation after this procedure is usually organized into progressive phases. The phases below describe the general shape only — specific exercises, precautions, and timelines are individual and are set by your surgeon and physical therapist.
Period of protection
The earliest period after surgery, focused on protecting a stable elbow — commonly in a splint or brace, with protected motion introduced within the safe arc your surgeon defines and forearm position as directed.
Advancing motion and early strengthening
As healing allows, progressing toward fuller elbow and forearm motion, weaning protection as directed, and beginning gentle strengthening within the limits your surgical team sets.
Strengthening and functional progression
Progressively rebuilding strength and control and addressing any persistent motion deficits as the elbow tolerates more.
Return to activity
A criteria-based return toward full activity and, when appropriate, sport — guided by restored motion, strength, and function and physician clearance rather than a fixed calendar.
This overview describes the general structure of rehabilitation only. It does not replace the specific instructions of your own surgical team, whose guidance always takes precedence. Timelines, the safe range of motion, forearm position, and loading are individual and are set for you at your appointments, and your operative note takes precedence. Use only the protocol your surgical team selected for you.