Classic Floating Elbow in Adults: A Case Series

Abstract

Background: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. Methods: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22−64 years) and the average follow-up period was 37.0 months (14−103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. Results: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final followup examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome.

Floating elbow, an uncommon clinical entity: A case report

“…The Classic Floating Elbow injuries and variants are uncommon injuries that have been reported in both children and Adults [1,2,3] . Stanistiki and Micheli [3] in 1980 first used the term "floating Elbow" to describe the injury pattern of ipsilateral supracondylar humerus and forearm fractures that create an unstable intermediate articulation in children.…”

Floating elbows in adults: epidemiology, clinical presentation, management and prognosis: Brazzaville Teaching Hospital experience

“…9 Floating elbows occur as a result of high energy trauma, sometimes involving soft tissue and / or neuro-vascular injury. [3][4][5][6][7][8][9][10] Considering the site of injury, the left thoracic limb was involved 3 times and the right thoracic limb 1 time in our study. The predominance of left hemisphere has been found in other studies.…”

“…Radial nerve paralysis during humeral shaft fractures has been reported in different studies. [3][4][5][6][7][8][9] Considering the prognosis, we noted a case of elbow stiffness and 1 case of aseptic non-union of the radius, associated with a stiffness of the elbow and a limitation of the prono-supination. Other authors have observed the same complications of fractures.…”

“…Other authors have observed the same complications of fractures. [2][3][4][5][6][7][8][9] Elbow stiffness and non-union are very common in trauma. They cause a significant functional disability in professional life.…”

“…Several series have reported classic floating elbows (association of fracture of the humeral shaft and diaphyseal fractures of the bones of the ipsilateral forearm) and non-classic floating elbows (combination of diaphyseal and epiphyseal fractures or epiphyseal fractures of the humerus and epiphyseal bones of the ipsilateral forearm) in children and adults. [3][4][5][6] They are usually due to high-energy trauma. Standard X-Ray of the humerus and ipsilateral forearm bones showing the upper and lower joints remains the first choice for diagnosis.…”