The floating elbow is an uncommon injury occurring both in children and in adults. Two reports of rare variants of floating elbow injury have been published, but to the best of our knowledge, no recurrence of this injury has been described. We present a complex pattern of floating injury, occurring in the same limb 3 years after a floating elbow lesion, which included supracondylar fracture of the humerus and associated ipsilateral midshaft fracture of forearm bones. Satisfactory outcomes were finally obtained. This clinical case illustrates the importance of carefully assessing floating elbow injuries when they occur to optimize the surgical strategies and the adequate timing of the treatment. A comprehensive literature review of the floating elbow injuries is here reported.
Stanitski CL, Micheli LJ (1980) Simultaneous ipsilateral fractures of the arm and forearm in children. Clin Orthop Relat Res 153:218-222
Templeton PA, Graham HK (1995) The ‘floating elbow’ in children. Simultaneous supracondylar fractures of the humerus and of the forearm in the same upper limb. J Bone Joint Surg Br 77:791-796
Lange RH, Foster RJ (1985) Skeletal management of humeral shaft fractures associated with forearm fractures. Clin Orthop Relat Res 195:173-177
Rogers JF, Bennett JB, Tullos HS (1984) Management of concomitant ipsilateral fractures of the humerus and forearm. J Bone Joint Surg Am 66:552-556
Solomon HB, Zadnik M, Eglseder WA (2003) A review of outcomes in 18 patients with floating elbow. J Orthop Trauma 17:563-570
Yokoyama K, Itoman M, Kobayashi A, Shindo M, Futami T (1998) Functional outcomes of “floating elbow” injuries in adult patients. J Orthop Trauma 12:284-290
Simpson NS, Jupiter JB (1995) Complex fracture patterns of the upper extremity. Clin Orthop Relat Res 318:43-53
De Carli P, Boretto JG, Bourgeois WO, Gallucci GL (2006) Floating dislocated elbow: a variant with articular fracture of the humerus. J Trauma 60:421-422
Sarup S, Bryant PA (1997) Ipsilateral humeral shaft and Galeazzi fractures with a posterolateral dislocation of the elbow: a variant of the “floating dislocated elbow”. J Trauma 43:349-352
Sathyamoorthy P, Kemp GJ, Rawal A, Rayner V, Frostick SP (2004) Development and validation of an elbow score. Rheumatology 43:1434-1440
Busam ML, Esther RJ, Obremskey WT (2006) Hardware removal: indications and expectations. J Am Acad Orthop Surg 14:113-120
Langkamer VG, Ackroyd CE (1990) Removal of forearm plates. A review of the complications. J Bone Joint Surg Br 72:601-604
Jones JA (1991) Immediate internal fixation of high-energy open forearm fractures. J Orthop Trauma 5:272-279
Pierce RO, Hodurski DF (1979) Fractures of the humerus, radius, and ulna in the same extremity. J Trauma 19:182-185