Terrible Triad of the Elbow: Proposal and Reliability Validation of a Novel CT-Based Alphanumeric Classification System

Background/Objectives: The terrible triad (TT) of the elbow combines elbow dislocation with radial-head and coronoid fractures. Existing systems classify either the individual osseous components or the broader spectrum of elbow fracture-dislocations, requiring multiple labels to describe the combined TT morphology. We propose a novel combined alphanumeric CT-based classification that integrates radial-head and coronoid morphology into one TT-specific code. The rationale is not merely terminological: the two axes correspond to osseous features routinely considered during preoperative planning and may therefore provide a compact, clinically oriented description in addition to standardising communication and research stratification.