Management of the floating elbow injury in children. Simultaneous ipsilateral fractures of the elbow and forearm.

Simultaneous ipsilateral fracture of the elbow and forearm--floating elbow--is an uncommon injury. During a 7-year period we prospectively followed 12 children who presented with completely displaced supracondylar fractures of the humerus associated with a forearm fracture of the same limb. All patients underwent emergency operative reduction and percutaneous K-wire stabilisation. At a minimum of 18 months, all patients were assessed clinically and radiologically and the results evaluated according to a conventional scoring system. Ten patients had good or excellent outcomes, and there were two fair results. The incidence of open fractures and nerve injury and the need to perform an open reduction were higher than those recorded for isolated supracondylar fractures. The floating elbow is an indicator of a high energy injury and requires aggressive operative management.