Ipsilateral fracture of the supracondylar humerus and forearm in children

Introduction: Simultaneous ipsilateral fracture of the elbow and forearm (floating elbow) is an uncommon injury and treatment recommendations are controversial. The aim of our study was to evaluate the incidence of ipsilateral fractures of the upper limb and to present our experience in dealing with such injuries and to review the literature relating to this topic. The following variables were used: age, gender, side, mechanism of injury, type of fracture, classification, treatment methods, complications and outcome. Case Series: We prospectively followed five children who presented with displaced supracondylar fractures of the humerus associated with a forearm fracture of the same limb. All patients underwent emergency procedures in the form of closed reduction and K-wire fixation/ cast fixation. At a minimum follow up of 24 months, all patients were assessed clinically and radiologically and the results evaluated according to a conventional scoring system. Four patients had excellent or good outcomes, and there was one poor result. Conclusion: The floating elbow is an indicator of a high energy injury. The incidence of open fractures, compartment syndrome and nerve injury and the need to perform an open reduction were higher than those recorded for isolated supracondylar or forearm fractures. The existing controversies in the management of such a complex injury and associated problems are outlined. A pertinent literature review is also included. (This page in not part of the published article.) IJCRI – International Journal of Case Reports and Images, Vol. 5 No. 3, March 2014. ISSN – [0976-3198] IJCRI 2014;5(3):189–194. www.ijcasereportsandimages.com Hussain et al. 189 CASE SEriES OPEN ACCESS Ipsilateral fracture of the supracondylar humerus and forearm in children