Epidemiology and injury patterns of floating elbow in Cotonou

Background: Floating elbow is an uncommon but severe injury pattern that occurs following high-energy trauma. The aim of this study was to analyze its epidemiological and anatomopathological characteristics.Material and Methods: This was a retrospective, descriptive, and analytical study conducted over ten years, from January 2014 to December 2023. It included patients admitted for floating elbow at the CNHU-HKM in Cotonou, all of whom had complete medical records. The variables studied included sociodemographic data, clinical findings, and radiographic characteristics.Results: We identified 20 cases of floating elbow, comprising 13 men and 7 women, with a sex ratio of 1.85. The mean age of patients was 36.65 ± 13.77 years (range 17– years). The injuries were caused by high-energy trauma, primarily traffic accidents (17 cases), often in the context of polytrauma (11 of 20 cases). Fractures were located on the left side in 11 patients and on the dominant side in half of the cases (10 cases). Closed bidiaphyseal fractures (S1, A0, O0 according to Agarwal and Chadha) were the most frequent (5 cases). Numerous associated lesions were observed, including 8 open fractures, 6 of which were Gustilo-Anderson type II; 4 nerve injuries (3 radial nerve lesions and 1 brachial plexus paralysis); 2 radial artery lacerations; 1 ulnar artery laceration; and multiple other osteoarticular injuries.Conclusion: Floating elbow is primarily an injury of young adult males. It typically results from high-energy trauma, and patients are often polytraumatized with multiple associated injuries, including cutaneous, vascular, and osteoarticular lesions.