Comparison of surgically treated floating elbow injuries and supracondylar humeral fractures in children.

The study compared 27 children with floating elbow injuries and 86 children with isolated supracondylar humeral fractures (SHF) treated surgically at one hospital.

• Retrospective analysis of patients treated between May 2016 and May 2023; 113 children enrolled in total.
• Floating elbow group: 22 males and 5 females, median age 8 years (IQR 6-11).
• SHF group: 58 males and 28 females, median age 8 years (IQR 5-10).
• Level of evidence III.

Mechanism of injury differed significantly between the floating elbow and SHF groups.

• Reported as p = 0.001.
• Mechanism of injury was one of the variables analyzed alongside sex, age, BMI, affected limb, fracture displacement, and Gartland classification.

Fracture type differed significantly between the floating elbow and SHF groups.

• Reported as p = 0.003.
• Type of injury (e.g., open vs closed) was among the analyzed variables.

Preoperative nerve injury differed significantly between the two groups.

• Reported as p = 0.001.
• Neurovascular injury presence was among the analyzed variables.

Within the floating elbow group, acute compartment syndrome (ACS) incidence differed significantly between open and closed fractures, with open fractures associated with higher ACS incidence.

• Reported as p = 0.028.
• The authors caution that the finding is based on a small number of events.
• ACS was defined by clinical criteria including pain, paresthesia, and/or compartment pressure > 30 mmHg.

No statistically significant difference in elbow function outcomes was detected between floating elbow and isolated SHF in this surgically treated cohort.

• Elbow function was evaluated with the Mayo Elbow Performance Score (MEPS).
• The authors state that larger studies are needed to confirm equivalence or identify clinically meaningful differences, since non-significance does not establish equivalence.