Karslı Burçin, İnce Kamil, Gönder Nevzat, Bozgeyik Bahri, Kılınçoğlu Volkan
Department of Orthopaedics and Traumatology, Faculty of Medicine, Gaziantep University, Gaziantep, 27310 Turkey.
Department of Orthopaedics and Traumatology, T.C. Ministry of Health Islahiye State Hospital, Gaziantep, 27800 Turkey.
Indian J Orthop. 2021 Jan 13;55(3):688-694. doi: 10.1007/s43465-020-00337-7. eCollection 2021 Jun.
The coexistence of supracondylar humerus fracture and forearm fracture is a rare trauma (3-13%) and it is called floating elbow. The aim of this study is to clinically compare the treatment outcomes of the patients diagnosed with floating elbow who underwent surgical treatment and who were followed up forearm with immobilization with splint.
When scanned retrospectively, 60 patients who were treated with the diagnosis of floating elbow due to traumatic causes and followed up for at least 1 year were included in our study. Surgical treatment was performed on 42 patients for forearm fracture. Eighteen patients followed up with immobilization with a long arm splint. The results were evaluated according to the criteria modified by Templeton and Graham, in comparison with the patient's intact side.
In the patients whose forearms were followed up conservatively, the mean age was 5.67 ± 2.25 years, and the mean follow-up period was 62.17 ± 45.91 months. In the patients who underwent surgery for the forearm, the mean age was 8.79 ± 2.01 years, and the mean follow-up was 47.14 ± 34.25 months. Eighteen patients whose forearms followed up conservatively, 12 had excellent and good clinical results and 6 had poor and moderate clinical results. Excellent and good clinical results in 27 patients who underwent surgical treatment for their forearms, moderate and poor clinical results obtained in 15 of them. There was no significant difference between the two groups ( = 0.357).
In conclusion, satisfactory clinical and radiological outcomes can be obtained with immobilization of the forearm fracture with splint, if acceptable reduction can be provided for the forearm following fixation of the supracondylar humerus fracture with the K-wire for treatment of floating elbow injury.
肱骨髁上骨折与前臂骨折并存是一种罕见的创伤（3%-13%），被称为漂浮肘。本研究的目的是对接受手术治疗的漂浮肘患者与采用夹板固定前臂进行随访的患者的治疗结果进行临床比较。
回顾性扫描时，本研究纳入了60例因创伤性原因诊断为漂浮肘并随访至少1年的患者。42例患者因前臂骨折接受了手术治疗。18例患者采用长臂夹板固定进行随访。根据Templeton和Graham修改的标准，与患者未受伤侧进行比较来评估结果。
保守随访前臂的患者，平均年龄为5.67±2.25岁，平均随访时间为62.17±45.91个月。接受前臂手术的患者，平均年龄为8.79±2.01岁，平均随访时间为47.14±34.25个月。18例保守随访前臂的患者中，12例临床结果为优和良，6例为差和中。27例接受前臂手术治疗的患者中，优和良的临床结果有27例，其中15例为中差。两组之间无显著差异（P=0.357）。
总之，对于漂浮肘损伤，若用克氏针固定肱骨髁上骨折后能为前臂提供可接受的复位，采用夹板固定前臂骨折可获得满意的临床和影像学结果。
