Acta Ortopédica Mexicana

Cuéllar RE, Nieto LL
A pronostical classification of the “floating elbow” in children
Acta Ortop Mex 2007; 21 (6)

Language: Español
References: 17
Page: 300-303
PDF: 124.33 Kb.

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ABSTRACT

The ipsilateral fracture of the humerus and any bone of the forearm is known as «Floating elbow», being this an infrequent entity in paediatrics. Nevertheless the classification that is proposed is based specifically on clinical findings and on the radiographic appearance resulting. We performed an observational, cross-sectioned and descriptive study from January 1997 to December 2000. We included 29 patients from 4 to 14 years old male and female. All patients received treatment for «floating elbow» and they were evaluated with the application of this proposition to get their prognosis. It was made on the basis of other classifications widely demonstrated such as Holmberg’s for supracondylar fractures, Kranhoft and Solgaard’s for forearm fractures, Gustilo R.B. and Mendoza R.M.’s for exposed fractures and we also considered the applications of the functional classification index of Broberg and Morrey. We propose a classification system based on mechanism of injury, fracture’s level, displacement, time of exposition and related injuries, with six different types, as well as the use of a prognostic classification the physician has to look for a perfect reduction of the fracture and an appropriate stabilization.


Key words: elbow, classification, radiology, prognosis, humeral fracture, ulnar fracture, radius fracture.


REFERENCES

  1. Stanitski, Carl L: Simultaneous ipsilateral fracture of the arm and forearm in children. Clin Orthop Rel Res 1980; 153: 218-22.

  2. Templeton Peter A: The «floating elbow» in children. J Bone Joint Surg 1995; 77-B(5): 791-6.

  3. Papasiliou V: Ipsilateral injuries of the elbow and forearm in children. J Pediatric Orthop 1986; 6: 58-60.

  4. Williamson DM. Treatment of ipsilateral supracondylar and forearm fractures in children; Injury. British J Acc Sur 1992; 23(3): 159-61.

  5. Daunois O: Supracondilar fracture of the humerus associated with ipsilateral fracture of the forearm. Rev Clin Orthop Rel Res 1992; 78(5): 333-9.

  6. Pierce OR: Fractures of the humerus, radius, and ulna in the same extremity. J Traum 1998; 19(3): 182-5.

  7. Högström H: Corrections with growth following diaphyseal forearm fracture. Act Orthop Scand 1976; 47: 299-303.

  8. Roberts JA: Angulation of the radius in children’s fractures. J Bone Joint Surg 1986; 68B(5): 751-4.

  9. Nilsson B, Obrant K. The range of motion following fracture of the shaft of the forearm in children. Act Orthop Scand 1977; 48: 600-2.

  10. Matthews L, Kaufer H, et al: The effect on supination-pronation of angular malalignment of fractures of both bones of the forearm. J Bone Joint Surg 1982; 64A(1): 14-7.

  11. Khare GN, Gautman VK, et al: Prevention of cubitus varus deformity in supracondylar fractures of the humerus. Injury 1991; 22(3): 202-6.

  12. Mubarak SJ, Owen Ch.A, et al: Acute compartment syndromes: diagnosis and treatment with the aid of the wick catheter. J Bone Joint Surg 1978; 60A(8): 1091-5.

  13. Blakemore LC, Cooperman D, et al: Compartment syndrome in ipsilateral humerus and forearm fractures in children. Clin Orthop Rel Res 2000; 376: 32-8.

  14. Holmberg L: Fractures of the distal end of the humerus in children. Acta Chir Scand 1945; 92,Suppl 103: 1-69.

  15. Kramhoft M, Solgaard S: Displaced diaphyseal forearm fractures in children: Classification and evaluation of the early radiographic prognosis. J Pediat Orthop 1989; 9: 586-9.

  16. Gustilo RB: Clasificación de las fracturas expuestas. J Trauma 1984; 24: 742.

  17. Broberg MA, Morrey BF: Results of delayed excision of the radial head after fracture. J Bone Joint Surg 1986; 68A(5): 669-74.