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. 2022 Jan 29;14(1):31843.
doi: 10.52965/001c.31843. eCollection 2022.

Floating Elbow in Adults: A Systematic Review and Meta-Analysis

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Floating Elbow in Adults: A Systematic Review and Meta-Analysis

Konstantinos Ditsios et al. Orthop Rev (Pavia). .

Abstract

Background: We aimed to systematically review all papers examining floating elbow injuries in adults.

Material and methods: MEDLINE, Cochrane Bone, Joint and Muscle Trauma, PROSPERO, and Scopus databases were searched up to August 31, 2020. Included studies had as a primary or secondary outcome the functional outcomes after a floating elbow injury on patients aged 17 or older. Methodological quality of the included studies was assessed.

Results: Thirty-two studies met the inclusion criteria. Patients were male at 73,1%. Median age of the patients was 33,0 years and median time of follow-up was 19,5 months. Articular surfaces were affected at 24,4%, whereas 51,2% of the fractures was open. Approximately, 34,9% of the patients suffered neural injury. Ipsilateral and multiple-system injuries were present in 34,8% and 76,3 % of the cases, respectively. Multivariate analysis showed that intra-articular and nerve damage, open fractures and multi-system injuries affected range of motion, union and complications. Sex, age, vascular damage and ipsilateral injuries of the patient did not adversely impact the outcome. All of the included studies were classified as very-low quality of evidence.

Conclusions: The current knowledge regarding the characteristics of floating elbow in adults is limited, albeit we were able to provide possible pre-operative predictor outcomes.

Keywords: complex injuries; floating elbow; forearm; humerus; review.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.. Floating elbow injuries are complex injuries involving concomitant fractures of the humerus and forearm in the same limb.
Figure 2.
Figure 2.. The treatment of floating elbow injuries is surgical. Most patients are treated with ORIF for both fractures, albeit intramedullary nail in certain cases is a valid option.
Figure 3.
Figure 3.. Study selection process and PRISMA flowchart.

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