Functional outcomes of "floating elbow" injuries in adult patients

被引:31
|
作者
Yokoyama, K
Itoman, M
Kobayashi, A
Shindo, M
Futami, T
机构
[1] Kitasato Univ, Sch Med, Dept Orthoped Surg, Sagamihara, Kanagawa 228, Japan
[2] Kitasato Emergency Trauma Serv, Kanagawa, Japan
[3] Kitasato Univ, East Hosp, Kanagawa, Japan
关键词
floating elbow injuries; adult; functional outcome; complications;
D O I
10.1097/00005131-199805000-00012
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objectives: To assess elbow function, complications, and problems of floating elbow fractures in adults receiving surgical treatment. Design: Retrospective clinical review. Setting: Level 1 trauma center in Kanagawa, Japan. Patients: Fourteen patients with fifteen floating elbow injuries, excluding one immediate amputation, seen at the Kitasato University Hospital from January 1, 1984, to April 30, 1995. Intervention: All fractures were managed surgically by various methods. In ten cases, the humeral and forearm fractures were treated simultaneously with immediate fixation. In three cases, both the humeral and forearm fractures were treated with delayed fixation on Day 1, 4, or 7. In the remaining two cases, the open forearm fracture was managed with immediate fixation and the humerus fracture with delayed fixation on Day 10 or 25. Main Outcome Measurements: All subjects underwent standardized elbow evaluations, and results were compared with an elbow score based on a 100-point scale. The parameters evaluated were pain, motion, elbow and grip strength, and function during daily activities. Complications such as infections, nonunions, malunions, and refractures were investigated. Results: Mean follow-up was forty-three months (range 13 to 112 months). At final follow-up, the mean elbow function score was 79 points, with 67 percent (ten of fifteen) of the subjects having good or excellent results. The functional outcome did not correlate with the Injury Severity Score of the individual patients, the existence of open injuries or neurovascular injuries, or the timing of surgery. There were one deep infection, two nonunions of the humerus, two nonunions of the forearm, one varus deformity of the humerus, and one forearm refracture. Conclusion: Based on the present data, we could not clarify the factors influencing the final functional outcome after floating elbow injury. These injuries, however, potentially have many complications, such as infection or nonunion, especially when there is associated brachial plexus injury. We consider that floating elbow injuries are severe injuries and that surgical stabilization is needed; beyond that, there are no specific forms of surgical treatment to reliably guarantee excellent results.
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收藏
页码:284 / 290
页数:7
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