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Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 5/2017

13.10.2016 | Original Article • ELBOW - TRAUMA

Analysis of complications after a floating elbow injury

verfasst von: Verónica Jiménez-Díaz, Ismael Auñón-Martín, Carlos Olaya-González, Miguel Aroca-Peinado, David Cecilia-López, Pedro Caba-Doussoux

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 5/2017

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Abstract

Background

The aim of the present study is to analyse complications after a floating elbow injury, attempting to establish which of them act as a poor prognosis factor regarding clinical and functional results.

Materials and methods

Twenty-three patients who suffered a floating elbow injury, treated at our institution from 2004 to 2013, were retrospectively reviewed. Patients were divided into four groups depending on the type of injury. An analysis of demographic data, associated injuries, treatment options and complications was carried out. Clinical evaluation was made by a conventional goniometer, testing flexo-extension and prono-supination ranges. For functional evaluation, the Mayo Elbow Performance Score was employed. Association between radioulnar synostosis, articular surface disruption, nerve injury and clinical and functional results was analysed.

Results

Patients with radioulnar synostosis had worse results in functional evaluation than patients without it (56.6 vs. 75); this difference was statistically significant (p = 0.05). Regarding intra-articular extension, we found statistical association with worse results in functional evaluation (p = 0.018); however, nerve palsy does not seem to influence functional results.

Conclusions

Radioulnar synostosis and intra-articular extension of the injury are poor prognosis factor in floating elbow.
Literatur
1.
Zurück zum Zitat Stanitski CL, Micheli LJ (1980) Simultaneous ipsilateral fractures of the arm and forearm in children. Clin Orthop 153:218–222 Stanitski CL, Micheli LJ (1980) Simultaneous ipsilateral fractures of the arm and forearm in children. Clin Orthop 153:218–222
2.
Zurück zum Zitat Rogers JF, Bennet JB, Tullos HS (1984) Management of concomitant ipsilateral fractures of the humerus and forearm. J Bone Joint Surg Am 66:552–556CrossRefPubMed Rogers JF, Bennet JB, Tullos HS (1984) Management of concomitant ipsilateral fractures of the humerus and forearm. J Bone Joint Surg Am 66:552–556CrossRefPubMed
3.
Zurück zum Zitat Viegas SF, William G, Riley S (1989) Floating dislocated elbow: case report and review of the literature. J Trauma 29(6):886–888CrossRefPubMed Viegas SF, William G, Riley S (1989) Floating dislocated elbow: case report and review of the literature. J Trauma 29(6):886–888CrossRefPubMed
4.
Zurück zum Zitat Sarup S, Bryant PA (1997) Ipsilateral humeral shaft and Galeazzi fractures with a posterolateral dislocation of the elbow: “Floating dislocated elbow”. J Trauma 43(2):349–352CrossRefPubMed Sarup S, Bryant PA (1997) Ipsilateral humeral shaft and Galeazzi fractures with a posterolateral dislocation of the elbow: “Floating dislocated elbow”. J Trauma 43(2):349–352CrossRefPubMed
5.
Zurück zum Zitat De Carli P, Boretto JG, Bourgeois WO, Gallucci GL (2006) Floating dislocated elbow: a variant with articular fracture of the humerus. J Trauma 60:421–422CrossRefPubMed De Carli P, Boretto JG, Bourgeois WO, Gallucci GL (2006) Floating dislocated elbow: a variant with articular fracture of the humerus. J Trauma 60:421–422CrossRefPubMed
6.
Zurück zum Zitat Galasso O, Mariconda M, Gasparini G (2011) Repeated floating elbow injury after high-energy trauma. Strat Traum Limb Recon 6:33–37CrossRef Galasso O, Mariconda M, Gasparini G (2011) Repeated floating elbow injury after high-energy trauma. Strat Traum Limb Recon 6:33–37CrossRef
7.
Zurück zum Zitat Jockel CR, Gardenal RM, Chen NC, Golden RD, Jupiter JB, Capomassi M (2013) Intermediate-term outcomes for floating elbow and floating elbow variant injuries. J Shoulder Elbow Surg 22:280–285CrossRefPubMed Jockel CR, Gardenal RM, Chen NC, Golden RD, Jupiter JB, Capomassi M (2013) Intermediate-term outcomes for floating elbow and floating elbow variant injuries. J Shoulder Elbow Surg 22:280–285CrossRefPubMed
8.
Zurück zum Zitat Ditsios K, Boutsiadis A, Papadopoulos P, Karataglis D, Givissis P, Hatzokos I, Christodoulou A (2013) Floating elbow injuries in adults: prognosis factors affecting clinical outcomes. J Shoulder Elbow Surg 22:74–80CrossRefPubMed Ditsios K, Boutsiadis A, Papadopoulos P, Karataglis D, Givissis P, Hatzokos I, Christodoulou A (2013) Floating elbow injuries in adults: prognosis factors affecting clinical outcomes. J Shoulder Elbow Surg 22:74–80CrossRefPubMed
9.
Zurück zum Zitat Lerner A, Stahl S, Stein H (2000) Hybrid external fixation in high-energy elbow fractures: a modular system with a promising future. J Trauma 49(6):1017–1022CrossRefPubMed Lerner A, Stahl S, Stein H (2000) Hybrid external fixation in high-energy elbow fractures: a modular system with a promising future. J Trauma 49(6):1017–1022CrossRefPubMed
10.
Zurück zum Zitat Carroll EA, Schweppe M, Langfitt M, Miller AN, Halvorson JJ (2012) Management of humeral shaft fractures. J Am Acad Orthop Surg 20(7):423–433CrossRefPubMed Carroll EA, Schweppe M, Langfitt M, Miller AN, Halvorson JJ (2012) Management of humeral shaft fractures. J Am Acad Orthop Surg 20(7):423–433CrossRefPubMed
11.
Zurück zum Zitat Bisinella G, Bellon N (2015) Floating elbow in a polytrauma patient: timing and surgical strategy. Injury 46(Suppl 7):S20–S22CrossRefPubMed Bisinella G, Bellon N (2015) Floating elbow in a polytrauma patient: timing and surgical strategy. Injury 46(Suppl 7):S20–S22CrossRefPubMed
12.
Zurück zum Zitat Pierce RO, Hodorski DF (1979) Fractures of the humerus, radius and ulna in the same extremity. J Trauma 19:182–185CrossRefPubMed Pierce RO, Hodorski DF (1979) Fractures of the humerus, radius and ulna in the same extremity. J Trauma 19:182–185CrossRefPubMed
13.
Zurück zum Zitat Yokoyama K, Itoman M, Kobayashi A, Shindo M, Futami T (1998) Functional outcomes of “floating elbow” injuries in adult patients. J Orthop Trauma 12:284–290CrossRefPubMed Yokoyama K, Itoman M, Kobayashi A, Shindo M, Futami T (1998) Functional outcomes of “floating elbow” injuries in adult patients. J Orthop Trauma 12:284–290CrossRefPubMed
14.
Zurück zum Zitat Solomon HB, Zadnik M, Eglseder WA (2003) A review of outcomes in 18 patients with floating elbow. J Orthop Trauma 17:563–570CrossRefPubMed Solomon HB, Zadnik M, Eglseder WA (2003) A review of outcomes in 18 patients with floating elbow. J Orthop Trauma 17:563–570CrossRefPubMed
15.
Zurück zum Zitat El Ibrahimi A, Shimi M, Daoudi A, Elmrini A (2012) Le coude flottant: étude rétrospective et revue de la littérature. Chi main 31:350–354CrossRef El Ibrahimi A, Shimi M, Daoudi A, Elmrini A (2012) Le coude flottant: étude rétrospective et revue de la littérature. Chi main 31:350–354CrossRef
16.
Zurück zum Zitat Bergeron SG, Desy NM, Bernstein M, Harvey EJ (2012) Management of posttraumatic radioulnar synostosis. J Am Acad Orthop Surg 20:450–458CrossRefPubMed Bergeron SG, Desy NM, Bernstein M, Harvey EJ (2012) Management of posttraumatic radioulnar synostosis. J Am Acad Orthop Surg 20:450–458CrossRefPubMed
17.
Zurück zum Zitat Anderson LD, Sisk D, Tooms RE, Park WI III (1975) Compression-plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg Am 57(3):287–297CrossRefPubMed Anderson LD, Sisk D, Tooms RE, Park WI III (1975) Compression-plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg Am 57(3):287–297CrossRefPubMed
18.
Zurück zum Zitat Bauer G, Arand M, Mutschler W (1991) Post-traumatic radioulnar synostosis after forearm fracture osteosynthesis. Arch Orthop Trauma Surg 110(3):142–145CrossRefPubMed Bauer G, Arand M, Mutschler W (1991) Post-traumatic radioulnar synostosis after forearm fracture osteosynthesis. Arch Orthop Trauma Surg 110(3):142–145CrossRefPubMed
19.
Zurück zum Zitat Garland DE, Dowling V (1983) Forearm fractures in the head-injured adult. Clin Orthop Relat Res 176:190–196 Garland DE, Dowling V (1983) Forearm fractures in the head-injured adult. Clin Orthop Relat Res 176:190–196
20.
Zurück zum Zitat Vince KG, Miller JE (1987) Cross-union complicating fracture of the forearm: part I. Adults. J Bone Joint Surg Am 69(5):640–653CrossRefPubMed Vince KG, Miller JE (1987) Cross-union complicating fracture of the forearm: part I. Adults. J Bone Joint Surg Am 69(5):640–653CrossRefPubMed
21.
Zurück zum Zitat Jupiter JB, Ring D (1998) Operative treatment of post-traumatic proximal radioulnar synostosis. J Bone Joint Surg Am 80(2):248–257CrossRefPubMed Jupiter JB, Ring D (1998) Operative treatment of post-traumatic proximal radioulnar synostosis. J Bone Joint Surg Am 80(2):248–257CrossRefPubMed
22.
Zurück zum Zitat Fernández DL, Joneschild E (2004) “Wrap around” pedicled muscle flaps for the treatment of recurrent forearm synostosis. Tech Hand Up Extrem Surg 8(2):102–109CrossRefPubMed Fernández DL, Joneschild E (2004) “Wrap around” pedicled muscle flaps for the treatment of recurrent forearm synostosis. Tech Hand Up Extrem Surg 8(2):102–109CrossRefPubMed
23.
Zurück zum Zitat Bell SN, Benger D (1999) Management of radioulnar synostosis with mobilization, anconeus interposition, and a forearm rotation assist splint. J Shoulder Elbow Surg 8(6):621–624CrossRefPubMed Bell SN, Benger D (1999) Management of radioulnar synostosis with mobilization, anconeus interposition, and a forearm rotation assist splint. J Shoulder Elbow Surg 8(6):621–624CrossRefPubMed
24.
Zurück zum Zitat Kaminemi S, Maritz NG, Morrey BF (2002) Proximal radial resection for posttraumatic radioulnar synostosis: a new technique to improve forearm rotation. J Bone Joint Surg Am 84(5):745–751CrossRef Kaminemi S, Maritz NG, Morrey BF (2002) Proximal radial resection for posttraumatic radioulnar synostosis: a new technique to improve forearm rotation. J Bone Joint Surg Am 84(5):745–751CrossRef
25.
Zurück zum Zitat Failla JM, Amadio PC, Morrey BF (1979) Post-traumatic proximal radio-ulnar synostosis: results of surgical treatment. J Bone Joint Surg Am 71(8):1208–1213CrossRef Failla JM, Amadio PC, Morrey BF (1979) Post-traumatic proximal radio-ulnar synostosis: results of surgical treatment. J Bone Joint Surg Am 71(8):1208–1213CrossRef
Metadaten
Titel
Analysis of complications after a floating elbow injury
verfasst von
Verónica Jiménez-Díaz
Ismael Auñón-Martín
Carlos Olaya-González
Miguel Aroca-Peinado
David Cecilia-López
Pedro Caba-Doussoux
Publikationsdatum
13.10.2016
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 5/2017
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-016-1866-8

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