Analysis of complications after a floating elbow injury

Eur J Orthop Surg Traumatol. 2017 Jul;27(5):607-615. doi: 10.1007/s00590-016-1866-8. Epub 2016 Oct 13.

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.

Keywords: Complications; Floating elbow; Prognosis; Radioulnar synostosis.

MeSH terms

  • Adult
  • Amputation, Surgical / adverse effects
  • Diaphyses / injuries
  • Elbow Injuries*
  • Elbow Joint / physiopathology
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation
  • Fractures, Open / complications
  • Fractures, Open / surgery
  • Fractures, Ununited / etiology
  • Humans
  • Humeral Fractures / complications*
  • Humeral Fractures / surgery
  • Intra-Articular Fractures / complications
  • Intra-Articular Fractures / physiopathology
  • Intra-Articular Fractures / surgery
  • Male
  • Middle Aged
  • Multiple Trauma / complications*
  • Multiple Trauma / physiopathology
  • Multiple Trauma / surgery
  • Phantom Limb / etiology
  • Radial Neuropathy / etiology
  • Radius Fractures / complications*
  • Radius Fractures / physiopathology
  • Radius Fractures / surgery
  • Range of Motion, Articular
  • Reoperation
  • Retrospective Studies
  • Surgical Wound Infection / etiology
  • Synostosis / etiology
  • Synostosis / physiopathology
  • Ulna Fractures / complications*
  • Ulna Fractures / surgery
  • Ulnar Neuropathies / etiology
  • Young Adult