Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
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 by Discipline 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).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
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.”

Keywords: Floating forearm; Advanced trauma life support; Internal fixation; Multiple fractures; Open fracture; Case report

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.