Clin Should Elbow.  2015 Mar;18(1):8-12. 10.5397/cise.2015.18.1.8.

Classic Floating Elbow in Adults: A Case Series

Affiliations
  • 1Department of Orthopedic Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. oscho5362@dsmc.or.kr

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 follow-up 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.
CONCLUSIONS
Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.

Keyword

Humerus; Radius; Ulna; Fracture; Floating elbow

MeSH Terms

Adult*
Demography
Elbow*
Follow-Up Studies
Fractures, Open
Humans
Humerus
Joints
Outcome Assessment (Health Care)
Radius
Retrospective Studies
Shoulder
Ulna
Visual Analog Scale
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