Imtiaz Hussain Dar¹, Mohammad Moosa^1,, Nasir Muzaffar¹

Simultaneous ipsilateral fracture of the elbow and forearm is an uncommon injury. In such injuries, the elbow is effectively dissociated from the rest of the limb. Hence this injury is also called ‘the floating elbow’. It is an indicator of a high energy injury and requires aggressive operative management. We present a unique case of a pediatric floating elbow in a nine year old boy. The supracondylar fracture was reduced under general anesthesia and fixed by percutaneous pinning with two crossed Kirshner (K) wires and the forearm fracture post reduction was managed conservatively by a Plaster of Paris long arm back slab. At 4 weeks post op, the slab was removed but only the lateral K wire could be visualized and removed. The child subsequently complained of pain in the upper arm and a prickly feeling in the skin. On examination, a sharp tip could be palpated in the upper arm and radiographs confirmed that the medial K wire had migrated into the upper arm. The K wire was removed under anesthesia and the patient started on range of motion exercises. He made an uneventful recovery with no residual side effects.

floating elbow, percutaneous pinning, K wire, migration