![]() ![]() ![]() Included studies were either randomized or nonrandomized, either prospective or retrospective cohort, case series or case control, all of them having as primary or secondary outcome the functional outcomes after an floating elbow injury. This study is registered with PROSPERO, number CRD42021229347. We also hand-searched the reference lists of identified trials and reviews, for further references, including those published in grey literature and unpublished trials. We did not apply any language restrictions and included all relevant articles up to August 31, 2020. 11 We searched PubMed through MEDLINE, Cochrane Bone, Joint and Muscle Trauma, PROSPERO and Scopus databases with the following key phrases: (((“float” OR “floated”) OR “floating”) OR “floats”) AND ((((((“elbow” OR “elbow”) OR “elbow joint”) OR (“elbow” AND “joint”)) OR “elbow joint”) OR “elbow s”) OR “elbows”). The systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for meta-analyses of interventional studies. MATERIAL AND METHODS Search strategy and selection criteria The secondary objective of the study is to identify possible outcome predictors of this type of injury. ![]() The primary objective of the study is to summarize the current knowledge reported in the literature surrounding floating elbow injuries. concluded that these injuries potentially have many complications, such as infection, nonunion, and neurovascular damage, which led to long-term functional disability of affected limb. 10 in their respective series did not find a clear risk factor for poor prognosis of these injuries among multiple factors, such as open fracture, vascular injury, time to fixation, injury severity score, and nerve injury. 1,4,5,9 Diaz, 9 Pierce, 6 and Yokoyama et al. Patients with extra-articular injuries seem to obtain a higher degree of range of motion and better scores in functional scales. 2,4,6–8 There is, however, controversy in the literature regarding the most appropriate classification, functional outcomes and prognostic factors of this type of injury.Ĭase series from Solomon, 1 Jockel 5 and Ditsios 4 and Diaz et al., 9 notice that development of residual nerve palsy associates with worse results in functional scales. Most patients are treated with ORIF for both fractures, albeit intramedullary nail in certain cases is a valid option.Īlthough literature describing functional outcomes in patients with floating elbow is limited, surgical treatment has been widely accepted and there is evidence that these injuries are treated most effectively with surgical stabilization of the humerus and the forearm using a plate or intramedullary nail. The treatment of floating elbow injuries is surgical. The current knowledge regarding the characteristics of floating elbow in adults is limited, albeit we were able to provide possible pre-operative predictor outcomes.įigure 2. All of the included studies were classified as very-low quality of evidence. Sex, age, vascular damage and ipsilateral injuries of the patient did not adversely impact the outcome. Multivariate analysis showed that intra-articular and nerve damage, open fractures and multi-system injuries affected range of motion, union and complications. Ipsilateral and multiple-system injuries were present in 34,8% and 76,3 % of the cases, respectively. Approximately, 34,9% of the patients suffered neural injury. Articular surfaces were affected at 24,4%, whereas 51,2% of the fractures was open. Median age of the patients was 33,0 years and median time of follow-up was 19,5 months. Thirty-two studies met the inclusion criteria. Methodological quality of the included studies was assessed. Included studies had as a primary or secondary outcome the functional outcomes after a floating elbow injury on patients aged 17 or older. MEDLINE, Cochrane Bone, Joint and Muscle Trauma, PROSPERO, and Scopus databases were searched up to August 31, 2020. We aimed to systematically review all papers examining floating elbow injuries in adults.
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