A Pediatric Floating Elbow Associating Flexion Type Supracondylar Fracture with Both Bone Forearm Fracture And Ulnar Nerve Irritation: A Case Report

INTRODUCTION: Pediatric floating elbow in the setting of flexion type-supracondylar fracture is exceptional. Most reported cases in the literature include the more common variant of supracondylar fracture which is the extension type. We report a rare case of pediatric floating elbow associating flexion type supracondylar fracture with both bone forearm fracture and ulnar nerve irritation. CASE REPORT: A 5-year-old boy presenting to the emergency department after sustaining a fall from 3 m height. At presentation, he had an S-shaped deformity of the left upper limb, along with ecchymosis of the medial side of the elbow and the anterior aspect of the forearm. He was also complaining of severe pain with numbness in the territories of the ulnar nerve at the level of the wrist and hand without any signs of the median nerve or radial nerve neuropraxia or injury. The primary assessment demonstrated left flexion type supracondylar fracture, along with ipsilateral radial shaft fracture and ulnar shaft fracture. The patient was treated surgically by open reduction internal fixation of the supracondylar fracture followed by closed reduction and fixation of both bone forearm fracture. CONCLUSION: This case is reported for the unique association of flexion type supracondylar fracture – a rare type of supracondylar fracture in children – with ipsilateral both bone forearm fracture in a setting of the floating elbow and a relatively low incident complication which is ulnar nerve neuropraxia.