A review of outcomes in 18 patients with floating elbow.
OBJECTIVE
To assess functional outcomes and predictors of success in floating elbow injuries.


METHODS
Retrospective clinical review.


METHODS
Level 1 trauma center.


METHODS
Eighteen patients with floating elbow injuries seen at the trauma center from 1995-2001.


METHODS
All injuries were managed surgically. Each forearm fracture was managed with open reduction and internal fixation. Humerus fractures were managed with either open reduction and internal fixation or intramedullary nail. Definitive fixation was performed in all cases within 48 hours of arrival at the trauma center.


METHODS
Eighteen patients were available for follow-up at a minimum of 1 year and consented to enroll in the study. Each patient was evaluated with a standardized elbow score based on a 100-point scale. These scores were correlated with injury features including age, severity of fracture (AO classification), open fractures, nerve injuries, vascular injuries, type of fixation on the humerus, and the presence of concomitant intra-articular elbow injuries.


RESULTS
The average elbow score was 68/100. Outcomes were divided into two groups. Eleven patients had a score greater than 75 (group I), with a mean score of 83, and were considered to have a good or excellent result. Seven patients had a score less than 75 (group II), with a mean score of 45, and were considered to have a satisfactory or poor result. The distribution of outcomes revealed two statistically distinct clusters. Additionally, there was a significantly higher incidence of nerve injuries in group 2 compared with group 1.


CONCLUSIONS
Functional outcomes in floating elbow injuries tend to cluster into two groups-patients with good or excellent results and patients with poor results. Patients with associated nerve injuries have lower functional outcomes at a minimum of 1-year follow-up.
D000293:Adolescent; D000328:Adult; D000368:Aged; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery*; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*; D000092464:Elbow Injuries