Huang GH, Tang JA, Yang TY, Liu Y. Floating elbow combining ipsilateral distal multiple segmental forearm fractures: A case report. World J Clin Cases 2021; 9(14): 3372-3378 [PMID: 34002147 DOI: 10.12998/wjcc.v9.i14.3372]
Corresponding Author of This Article
Yue Liu, MD, Associate Chief Physician, Department of Orthopedics, Shanghai Pudong New Area Gongli Hospital, Affiliated to the Second Military Medical University, No. 219 Miaopu Road, Pudong New Area, Shanghai 200135, China. lliuyuee@126.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2021; 9(14): 3372-3378 Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3372
Floating elbow combining ipsilateral distal multiple segmental forearm fractures: A case report
Guo-Hua Huang, Jiang-An Tang, Tie-Yi Yang, Yue Liu
Guo-Hua Huang, Jiang-An Tang, Tie-Yi Yang, Yue Liu, Department of Orthopedics, Shanghai Pudong New Area Gongli Hospital, Affiliated to the Second Military Medical University, Shanghai 200135, China
Author contributions: Huang GH, Tang JA, and Liu Y were the patient’s surgeons, reviewed the literature and contributed to manuscript drafting; Yang TY was responsible for revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported byDiscipline Construction Project of Characteristic Clinic of Pudong New Area Health Commission, China, No. PWYts2018-03; Research Grant for Health Science and Technology of Pudong Health and Family Planning Commission of Shanghai, China, No. PW2020A-28; Top-notch Talent Training Program of Pudong Gongli Hospital, China, No. GLRb2020-04.
Informed consent statement: All involved persons (subjects or legally authorized representative) gave their informed consent (written or verbal, as appropriate) prior to study inclusion.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Yue Liu, MD, Associate Chief Physician, Department of Orthopedics, Shanghai Pudong New Area Gongli Hospital, Affiliated to the Second Military Medical University, No. 219 Miaopu Road, Pudong New Area, Shanghai 200135, China. lliuyuee@126.com
Received: November 12, 2020 Peer-review started: November 12, 2020 First decision: January 29, 2021 Revised: February 4, 2021 Accepted: February 26, 2021 Article in press: February 26, 2021 Published online: May 16, 2021 Processing time: 168 Days and 7.1 Hours
Abstract
BACKGROUND
Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury, although elbow dislocation or fracture of the ulna and radius may occur separately.
CASE SUMMARY
We report the case of a 37-year-old woman with open (IIIA) fracture of the right distal humerus with multiple shaft fractures of the ipsilateral radius and ulna with a history of falling from a height of almost 20 m from a balcony. After providing advanced trauma life support, damage control surgery was performed to debride the arm wound and temporarily stabilize the right upper limb with external fixators in the emergency operating room. Subsequently, one-stage internal fixation of multiple fractures was performed with normal values of biochemical indicators and reduction in limb swelling. The patient achieved good outcome at the 7 mo follow-up.
CONCLUSION
One- or two-stage treatment must be performed according to the type of injury; we efficiently used the “damage control principle.”
Core Tip: A 37-year-old woman was admitted to our hospital due to polytrauma. Initial emergency examinations showed open (IIIA) fracture of the distal right humerus; closed right olecranal fracture; multiple segment (shaft and distal) fracture of the radius and ulna. To date, the acknowledged guideline of “floating elbow” is still controversial, but the “damage control principle” was efficiently used for first aid and further treatment, and further research is needed.
