eMedicine Specialties > Orthopedic Surgery > Elbow

Floating Elbow: Follow-up

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

Outcome and Prognosis

The functional outcomes of these injuries vary in children and adult patients. Pediatric injuries historically have had better results than those of their adult counterparts, largely due to children's ability to remodel skeletal deformity with time. In Stanitski's series of 6 patients,13 all had an excellent outcome with respect to range of motion and carrying angle. Papavasiliou reviewed 24 cases and found similar results using the same treatment principles.9 Templeton studied 8 subjects with similar clinical presentation and found 7 had good or excellent results and 1 had a poor result (cubitus varus with limited but functional supination/pronation).14

Yokoyama et al reviewed a series of floating elbow injuries in adults.18 The surgical management varied from case to case, but each fracture was managed with some type of operative intervention. All patients underwent standardized elbow evaluations, and a review of pertinent complications was included. They had 67% good or excellent results; the final elbow score did not correlate with timing of operation, concomitant neurovascular injury, or open fracture. Nonunions were present in 4 cases. All of these were fractures treated with unlocked intramedullary fixation.

Pierce and Hodorski reviewed 21 cases and only had 28% good results, with residual neurologic dysfunction in more than 50% of their patients. Lange reported on their experience with 7 patients, with 3 good, 1 fair, and 3 poor results.7 As advances in fracture fixation and understanding of the basic science of fracture healing have improved with time, so have the results of these devastating injuries.

Future and Controversies

As methods of fracture care improve, especially in patients with multiple fractures, outcomes of these complex injuries should mirror those efforts. A wide multicenter review of these complex injuries would be helpful in further guiding the understanding of the pathology and treatment options in the floating elbow.

 


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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  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.

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  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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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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