Traumatic Floating Bone. About 11 Cases and a Literature Review

Abstract

Introduction: Floating bone injury or bipolar dislocation is a concurrent dislocation at both ends of a long bone or a flat bone. It is an exceptional injury. We report 11 consecutives cases of floating bones. Objectives: The aim of the study is to analyze the frequency, the mechanism of injury and clinical forms of floating bones, and to present the results of their management. Material and Methods: A ten years ongoing retrospective study was held in four trauma departments. Eleven cases of floating bones were identified. The floating bones characteristics such as the injured bone, the patient age and sex, the mechanism of injury, the dislocations directions, the associated complications, the treatment and the outcome were studied. Results: Nine male and two female patients, with a mean age of 37 years [19 -65 years range] presented a concurrent bipolar dislocation of one bone or a group of bones. They sustained a road traffic accident (n = 5), a workplace accident (n = 3), a fall from height (n = 2), and a sport accident (n = 1). The clavicle (n = 3) and the first metatarsal (n = 3) were the most frequently involved. The others floating bones were the radius-ulna complex (n = 1), the radius-lunatum complex (n = 1), the first metacarpal (n = 1), the first phalanx (n = 1) and the femur (n = 1). The floating bones ends displacement occurred in the sagittal plane (the forearm, the femur, the first phalanx and the first metatarsal) and in the horizontal plane (the clavicle, the first metatarsal and the first metacarpal). We defined direction displacements as bidirectional asymmetric (n = 10) or unidirectional symmetric (n = 1). Associated complications were fractures (wrist, hip, tarso-metatarsal joints) and wounds (fingers, metatarso-phalangeal joint). Dislocations were treated conservatively (n = 5) and surgically (n = 17) with excellent results (n = 13/16 joints). Three patients were lost of view. Conclusion: Our study described the characteristics of How to cite this paper: Kasse, A.N.,

A rare case of floating fifth metacarpal and review of literature

“…Management goal of any dislocated joint is congruent relocation and stability, as described by Kasse et al in their case series report [11]. This is as well true for such double dislocation injuries.…”