# Floating Elbow in Children as a Serious Domestic Accident: A Case Report

## TL;DR

A three-year-old boy suffered a rare 'floating elbow' injury from a domestic accident and made a successful recovery after emergency surgery.

## Contribution

This case report highlights the risk of domestic accidents in children during the pandemic and the effectiveness of surgical intervention for complex fractures.

## Key findings

- The patient had a Grade IIIA open humerus fracture and forearm bone fractures from a centrifuge accident.
- Surgical treatment with external fixator and titanium elastic nails led to functional recovery without nerve damage.
- The case emphasizes the need for parental vigilance to prevent domestic injuries in children.

## Abstract

The "floating elbow" is a rare and complex traumatic injury predominantly seen in the pediatric population. It is characterized by simultaneous fractures of the humerus and one or both forearm bones. This article delves into the case of a three-year-old boy who sustained severe injuries to his right arm following a domestic accident involving a centrifuge. The child presented with a Grade IIIA (Gustilo/Anderson classification) open fracture of the humerus, accompanied by fractures in both forearm bones. In response to this critical situation, emergency surgery was performed, initially employing damage control techniques with an external fixator debridement and irrigation. This was followed by a secondary operation utilizing intramedullary titanium elastic nails (TENs) to stabilize the fractures. Despite encountering complications such as radial nerve neuropraxia and wrist drop, the patient demonstrated a promising recovery trajectory. He regained functional elbow movement and did not suffer from any disabling nerve damage such as nervous palsy. This case highlights the increased risk of domestic accidents, particularly during the COVID-19 pandemic, when children spend more time at home, thus becoming more susceptible to such injuries. The article underscores the critical role of surgical intervention in managing complex fractures and advocates for increased parental vigilance to prevent domestic accidents in children.