floating elbow in children

Floating elbow injury in children is uncommon, treatment modalities are controversial; varying between the conservative and the surgical methods. Closed reduction and minimally invasive fixation were the treatment protocol in the current study. Concomitant ipsilateral supracondylar humerus and forearm fractures in 14 children were treated by immediate closed reduction and percutaneous fixation. All fractures were dis-placed, and were open in 3 children. Vascular insufficiency was present in 5; it improved after fractures reduction and fixation. Nerve palsy was diagnosed in 6; it resolved spontaneously within 12 weeks after injury. There was no compartment syndrome.Were assessed clinically and radiographically at a minimum of 18 months after injury. Twelve children had excellent or good and 2 had fair results. Favorable outcome could be obtained with less complications

Elbow posterior dislocation with radial head and coronoid fractures

Twenty-two patients who had acute posterior dislocation of 22 elbows associated with radial head and coronoid fractures; were included in a prospective study to determine the clinical and radio-graphic results after early treatment by operative reduction and fixation of the coronoid fractures or and repair of its capsular attachment, reduction and fixation of the radial head fractures or metallic prosthetic replacement, repair of the lateral ligament complex and the medial collateral ligament; and early postoperative mobilization. The mean age was 38.6 years. The mean timing of surgery was 2.5 days. The mean follow-up period was 38 months [26 to 60] for 18 patients, while 4 patients missed the evaluation at one year postoperatively without apparent complications at that time. The mean flexion-extension arc of the elbow was 115° +/- 12° and the mean forearm rotation arc was 140° +/- 14°. The mean Mayo Elbow Performance Score was 85 points [60 to 100]; that corresponded to excellent results in 6patients [33.3%], good in 8 [44.5%] and fair in 4 [22.2%]. Seven patients [38.9%] developed mild and moderate radiographic arthritic changes. Additional surgery was performed in 8 patients [44.4%]; for wound infection in one, resection of synostosis in one and symptomatic hardware removal in 6 patients. Recurrent instability occurred in one patient who accepted the fair result. The treatment protocol used in the current study has produced a relatively high rate of satisfactory results. It is recommended to treat the elbow fracture-dislocation by early adequatesurgical management of the capsulo-ligamen-tous and bony stabilizers of the elbow; with early postoperative joint mobilization