Evaluation of surgical or conservative treatment of forearm fracture in pediatric floating elbow injuries

S.A. Ulus, R. Atiç, Ş. Yiğit, M.S. Akar, S. Dönmez, E. Özkul

Department of Orthopedics and Traumatology, Dicle University Medical School, Diyarbakır, Turkey. sanil.ulus@dicle.edu.tr

---

• Orthopedics

OBJECTIVE: Floating elbow, which refers to a humerus fracture in the supracondylar region and a forearm fracture, is a very unusual injury. The purpose of this study is to compare the clinical results of patients with “floating elbows” who underwent surgical therapy and who were given forearm immobilization with a splint as follow-up care.

PATIENTS AND METHODS: Fifteen patients who had been diagnosed with floating elbow owing to trauma were scanned retrospectively and followed up for at least a year. Eight individuals who suffered from broken forearms underwent surgical repair. After initial treatment, a lengthy arm splint was used to immobilize seven patients’ arms. The modified Flynn criteria were used to analyze the data, and comparisons were made between the groups.

RESULTS: The median age and mean follow-up time for patients whose forearms were conservatively followed was 6.1 years and 13.8 months, respectively. The median age of the patients who underwent forearm surgery was 8.5 years, and the average follow-up was 14.2 months. Five of the seven patients whose forearms underwent conservative follow-up had outstanding clinical outcomes, while two had poor and moderate outcomes. Four individuals who got surgical treatment for their forearms had excellent and good clinical outcomes, while the other four had intermediate and poor outcomes. Between the two groups, there was no discernible difference (p = 0.60).

CONCLUSIONS: In the pediatric population with floating elbow injuries, using a cast for forearm fractures may not necessarily result in worse outcomes compared to surgical management.

Free PDF Download