eMedicine Specialties > Orthopedic Surgery > Elbow

Floating Elbow: Workup

Author: William Oros, MD, Physician, Department of Orthopedics, University of Tennessee Medical Center - Knoxville
Coauthor(s): John J Walsh IV, MD, Associate Professor, Department of Orthopedic Surgery, University of South Carolina School of Medicine
Contributor Information and Disclosures

Updated: Jan 25, 2008

Workup

Imaging Studies

  • The minimum radiographic workup for a patient with an injured extremity should include radiographs in the anteroposterior (AP) and lateral planes.
  • Traction on the affected extremity helps define the fracture lines.
  • Obtain oblique radiographs when standard radiographs do not provide enough information.

Diagnostic Procedures

  • Patients with a persistent pulseless extremity despite fracture reduction should undergo arteriography to rule out vascular injury if a delay in operative intervention is anticipated.

More on Floating Elbow

Overview: Floating Elbow
Workup: Floating Elbow
Treatment: Floating Elbow
Follow-up: Floating Elbow
Multimedia: Floating Elbow
References
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References

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  2. Grace TG, Eversmann WW Jr. Forearm fractures: treatment by rigid fixation with early motion. J Bone Joint Surg Am. Apr 1980;62(3):433-8. [Medline].

  3. Grant JCB, Basmajian J. Grant's Method of Anatomy: a Clinical Problem-Solving Approach. 11th ed. Baltimore, Md: Lippincott, Williams & Wilkins; 1989:387-406.

  4. Harrington P, Sharif I, Fogarty EE, et al. Management of the floating elbow injury in children. Simultaneous ipsilateral fractures of the elbow and forearm. Arch Orthop Trauma Surg. 2000;120(3-4):205-8. [Medline].

  5. Hoppenfeld S, deBoer P, Thomas H. Surgical Exposures in Orthopaedics: The Anatomic Approach. 2nd ed. Baltimore, Md: Lippincott, Williams & Wilkins; 1994:1-146.

  6. Jones JA. Immediate internal fixation of high-energy open forearm fractures. J Orthop Trauma. 1991;5(3):272-9. [Medline].

  7. Lange RH, Foster RJ. Skeletal management of humeral shaft fractures associated with forearm fractures. Clin Orthop. May 1985;(195):173-7. [Medline].

  8. Moed BR, Kellam JF, Foster RJ, et al. Immediate internal fixation of open fractures of the diaphysis of the forearm. J Bone Joint Surg Am. Sep 1986;68(7):1008-17. [Medline].

  9. Papavasiliou V, Nenopoulos S. Ipsilateral injuries of the elbow and forearm in children. J Pediatr Orthop. Jan-Feb 1986;6(1):58-60. [Medline].

  10. Rogers JF, Bennett JB, Tullos HS. Management of concomitant ipsilateral fractures of the humerus and forearm. J Bone Joint Surg Am. Apr 1984;66(4):552-6. [Medline].

  11. Sarup S, Bryant PA. Ipsilateral humeral shaft and Galeazzi fractures with a posterolateral dislocation of the elbow: a variant of the "floating dislocated elbow.". J Trauma. Aug 1997;43(2):349-52. [Medline].

  12. Simpson NS, Jupiter JB. Complex fracture patterns of the upper extremity. Clin Orthop. Sep 1995;(318):43-53. [Medline].

  13. Stanitski CL, Micheli LJ. Simultaneous ipsilateral fractures of the arm and forearm in children. Clin Orthop. Nov-Dec 1980;(153):218-22. [Medline].

  14. Templeton PA, Graham HK. 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. Sep 1995;77(5):791-6. [Medline].

  15. Viegas SF, Gogan W, Riley S. Floating dislocated elbow: case report and review of the literature. J Trauma. Jun 1989;29(6):886-8. [Medline].

  16. Wallny T, Westermann K, Sagebiel C, et al. Functional treatment of humeral shaft fractures: indications and results. J Orthop Trauma. May 1997;11(4):283-7. [Medline].

  17. Wallny TA, Wietoska I, Kastning S, Westermann K. [Functional fracture treatment of the forearm. The indications and results]. Chirurg. Nov 1997;68(11):1126-31. [Medline].

  18. Yokoyama K, Itoman M, Kobayashi A, et al. Functional outcomes of "floating elbow" injuries in adult patients. J Orthop Trauma. May 1998;12(4):284-90. [Medline].

  19. Serra C, Delattre O, Dintimille H, Dib C, Rouvillain JL, Catonne Y. [Allograft-prosthesis composite arthroplasty for posttraumatic floating elbow]. Rev Chir Orthop Reparatrice Appar Mot. May 2006;92(3):269-74. [Medline].

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  21. Solomon HB, Zadnik M, Eglseder WA. A review of outcomes in 18 patients with floating elbow. J Orthop Trauma. Sep 2003;17(8):563-70. [Medline].

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Further Reading

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Keywords

floating elbow, traffic elbow, sideswipe injuries, elbow pain, humerus fracture, radius fracture, ulna fracture

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Contributor Information and Disclosures

Author

William Oros, MD, Physician, Department of Orthopedics, University of Tennessee Medical Center - Knoxville
William Oros, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Coauthor(s)

John J Walsh IV, MD, Associate Professor, Department of Orthopedic Surgery, University of South Carolina School of Medicine
John J Walsh IV, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Society for Surgery of the Hand, and Christian Medical & Dental Society
Disclosure: Nothing to disclose.

Medical Editor

Joseph E Sheppard, MD, Associate Professor of Clinical Orthopedic Surgery, Chief of Hand and Upper Extremity Service, Department of Orthopedic Surgery, University of Arizona Health Sciences Center, University Physicians Healthcare
Joseph E Sheppard, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Society for Surgery of the Hand, Clinical Orthopaedic Society, and Western Orthopaedic Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Pekka A Mooar, MD, Professor, Department of Orthopedic Surgery, Temple University School of Medicine
Pekka A Mooar, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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