Woosang Lee Henry Pollard


Background: Term ‘the terrible triad of the elbow’ describes posterior dislocation with fracture of radial head and coronoid process, and tear of lateral collateral ligament (LCL) complex. This type of injury is historically known to be a challenging injury to rehabilitate. This paper presents a case of the “terrible triad” type injury acquired by a Brazilian Jiu-Jitsu (BJJ) practitioner during a training session and who received chiropractic post-surgical rehabilitation.

Case presentation: A 26-year-old Asian male injured his left elbow during BJJ training session. After transport to the hospital, closed reduction in the emergency was attempted twice but failed to reduce radial head dislocation. Later, CT scan revealed a tear of the LCL complex and a fracture dislocation of the radial head.

Intervention and outcome: The injury was managed surgically via open reduction and internal fixation procedure. The patient chose to receive chiropractic post-surgical rehabilitation. The outcome of treatment was measured using patient reported outcome measures and achieved desirable outcome after 12 weeks of management which consisted of total 15 treatment sessions. The elbow motion arc improved from 60° (extension 60° - flexion 120°) to 150° (extension 5° - flexion 155°). His Disabilities of the Arm, Shoulder, and Hand score improved by 78.3 points, Patient Rated Elbow Evaluation score increased by 61 points, and Upper Extremity Functional Index achieved a full score.

Conclusion: This report discusses the post-surgical chiropractic rehabilitation of a unique BJJ-related injury. Despite the limitation of available literature to guide development, multimodal chiropractic rehabilitation can be successful in post-surgical rehabilitation.


Case Reports