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The floating elbow: uncommon association

The floating elbow: uncommon association

Ayoub Bouya, Mohammed Benchakroun


1Orthopedic Trauma Service I, Military Training Hospital Mohamed V, Rabat, Morocco



&Corresponding author
Ayoub Bouya, Orthopedic Trauma Service I, Military Training Hospital Mohamed V, Rabat, Morocco



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The floating elbow is a term first used in 1980 by Stanitski and Micheli. It is an uncommon entity in adults and corresponds to a humerus fracture associated with a homolateral fracture of one or both forearm bones. A 69-year-old female with type 2 diabetes under diet, admitted to the emergency following a fall. She complained of pain and functional impotence in her right upper limb. Motion attempts of the shoulder and elbow were painful. The neurovascular exam was normal. X-rays showed a proximal humerus fracture (Duparc 2) associated with a homolateral olecranon fracture (A,B). The wrist X-ray was normal. This association was classified S3 A3 O0 according to the Agarwal and Chadha Universal Classification of floating trauma. A posterior approach of elbow allowed both fixations. The gesture consisted of olecranon fixation by tension band wiring followed by humerus fixation by Hackethal intramedullary nailing (C,D). A posterior elbow splint was kept for 15 days. Passive functional rehabilitation began in the 2nd week with elbow motion on extension flexion followed in the 4th week by abduction and external rotation motion of the shoulder. After 5 months' follow-up, the patient retained an elbow extension deficit of 10 and a shoulder abduction of 120 without impacting her quality of life.



Figure 1: (A,B,C,D) floating elbow