Ipsilateral fractures of both the proximal and distal humerus; the ‘floating arm injury’ in children

Authors

  • Paragjyoti Gogoi Department of Orthopedics and Trauma, Guwahati Medical College, Guwahati, Assam, India
  • Aditi Das Department of Radio-Diagnosis, Silchar Medical College, Silchar, Assam, India
  • Arijit Dhar Department of Orthopedics and Trauma, Silchar Medical College, Silchar, Assam, India
  • Rajdeep Roy Departmwnt of Orthopedics, Jibon Jyoti Hospital, Silchar, Assam, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20210643

Keywords:

Floating arm, Proximal humerus fracture, Supracondylar fracture humerus, Ipsilateral, Bipolar

Abstract

Proximal humerus fractures are usually associated with other injuries in and around the shoulder joint like clavicle fracture, acromion process fracture, coracoid process fracture, and dislocation of the shoulder joint or acromion-clavicular joint. Similarly, distal humerus fractures are normally associated with fractures of olecranon, radial head or dislocation of the elbow joint itself. However, simultaneous fracture of both the ends of humerus is rarely encountered. Literature search does reveal only a few cases of such type. This variety is also termed as floating arm. We are presenting here two cases of fracture of both the proximal and distal end of same humerus following fall from height, one of which the proximal humeral fracture was Gustillo-Anderson type II open fracture. The patient was managed by wound debridement and open reduction and fixation of the proximal fracture followed by closed manipulation and K wire fixation of the distal fracture. The second case was also managed by closed reduction and K wire fixation of both the fractures. 

Author Biographies

Paragjyoti Gogoi, Department of Orthopedics and Trauma, Guwahati Medical College, Guwahati, Assam, India

Assistant Professor

Department of Orthopaedics and Trauma

Gauhati Medical College, Guwahati

Assam, India

Aditi Das, Department of Radio-Diagnosis, Silchar Medical College, Silchar, Assam, India

Assistant Professor
Department of Radio-diagnosis

Silchar Medical College

Silchar, Assam, India

Arijit Dhar, Department of Orthopedics and Trauma, Silchar Medical College, Silchar, Assam, India

Associate Professor

Department of Orthopaedics and Trauma

Silchar Medical College, Silchar

Assam, India

Rajdeep Roy, Departmwnt of Orthopedics, Jibon Jyoti Hospital, Silchar, Assam, India

Consultant Orthopaedics Surgeon

References

Kasser JR, Beaty JH. Supracondylar fractures of the distal humerus. In Rockwood and Wilkins’ Fractures in Children. Edited by Beaty JH, Kasser JR. 5th edition. Volume 1. Philadelphia: Lippincott Williams and Wilkins. 2001:617-21.

Stanitski CL, Micheli LJ. Simultaneous ipsilateral fractures of the arm and forearm in children. Clin Orthop Relat Res. 1980;(153):218-22.

Egol KA, Connor PM, Karunakar MA, Sims SH, Bosse MJ, Kellam JF. The floating shoulder: clinical and functional results. J Bone Joint Surg Am. 2001;83-A(8):1188-94.

Guven M, Akman B, Kormaz T, Poyanli O, Altintas F. "Floating arm" injury in a child with fractures of the proximal and distal parts of the humerus: a case report. J Med Case Rep. 2009;3:9287.

Gausepohl T, Mader K, Kirchner S, Pennig D. The "floating fore- arm" injury in a child: a case report. Strategies Trauma Limb Recon- str. 2007;2(1):48-54.

Themistocleous GS, Boscainos PJ, Apostolou CD, Triantafillopoulos IK, Papagelopoulos PJ, Korres DS. Ipsilateral fractures of the proximal, mid- shaft and distal humerus. Ortho Surg. 2004;14(1):32-4.

James P, Heinrich SD. Ipsilateral proximal metaphyseal and flexion supracondylar humerus fractures with an associated olecranon avulsion fracture. Orthopedics. 1991;14:713-6.

Gül A, Sambandam S. Ipsilateral proximal and flexion supra-condylar humerus fracture with an associated olecranon fracture in a 4-year-old child: a case report. Eur J Orthop Surg Traumatol. 2006;16:237-9.

Peivandi MT, Ashraf H, Shahpari O, Mostafavian Z, Azami M, Mirkazemi M et al. Ipsilateral Traumatic Fractures of the Proximal and Distal Parts of the Humerus (Floating Arm) With Fracture of Distal Clavicle: A Case Report. Iranian Red Crescent Medi J. 2013;15(6):534-5.

Parmaksizoglu AS, Ozkaya U, Bilgili F, Sayin E, Kabukc- uoglu Y. Closed reduction of the pediatric supracondylar humerus fractures: the "joystick" method. Arch Orthop Trauma Surg. 2009;129(9):1225-31.

Downloads

Published

2021-02-23

Issue

Section

Case Reports