Objective: To conduct a descriptive analysis on 31 cases of children with floating elbow who were attended at our clinic between 1994 and 2009, and to review the literature relating to this topic. Methods: Data were obtained through examining the medical records. The following variables were used: age, gender, side, mechanism, type of fracture, classification, treatment and complications. Results: Twenty-four patients (77.4%) were male and seven (22.6%) were female. The mean age was 8.5 (± 3.2) years, ranging from one to 14 years. The left side was predominantly affected (67.7%). The commonest injury mechanism was a fall from a height (74.2%). All the supracondylar fractures were Gartland type III. Distal radius fractures alone, of Salter-Harris type II, were diagnosed in 22 patients (71%). Open fractures occurred in 22 cases (71%). Closed reduction and application of a plaster cast for a closed fracture of the distal radius was performed in two patients (6.45%). Simultaneous conservative treatment for two fractures was not used. Sixteen supracondylar fractures (54.8%) were fixed using crossed wires, at 90° to each other, and in 14 cases (45.16%), an intramedullary wire was used together with another wire introduced through the lateral epicondyle at 45°. The following complications were observed: deformed consolidation (10%), nerve injuries (6%), compartment syndrome (3%) and pin path infection (16%). Conclusions: This is an uncommon injury that in most cases results from high-energy trauma. Surgical treatment for both fractures is recommended by most authors. Ulnar nerve injuries were correlated with the fixation method, but no neurological injuries were triggered by the initial trauma.

Objective With the objective of identifying the incidence of ipsilateral knee ligament injury, thirty-six patients with femoral shaft fractures were evaluated. Methods During the osteosynthesis procedure to repair the femur while under anesthesia, all patients underwent a physical examination and X-ray examination. Results The most common mechanism of injury observed was motorcycle accidents. Of the thirty-six patients that were studied, eleven patients (30.5%) had a knee ligament injury. Of the eleven patients, 64% had a cruciate ligament injury. The ligament injury was not treated at the time of the osteosynthesis procedure. Conclusion We highlight the difficulty of diagnosis at the time of admission and the need for systematic physical examination before and after surgical treatment of femoral fracture.

Foram avaliados 71 pacientes com idade abaixo de 16 anos, portadores de 72 fraturas diafisárias do fêmur, ocorridas de 01/1995 a 12/1998. Os objetivos do estudo foram conhecer aspectos descritivos dessas fraturas e avaliar o tratamento empregado. A idade foi o principal critério para escolha do tratamento, sendo aqueles abaixo de 3 anos (Grupo I) tratados com gesso imediato, os de 3 a 10 anos (Grupo II) com gesso após tração e os acima de 11 anos (Grupo III) de modo conservador ou cirúrgico. A média de idade foi 6,3±3,8 anos, havendo predomínio do gênero masculino e de fraturas fechadas. Acidente de trânsito foi o mecanismo de lesão mais comum. A fratura localizou-se no terço médio, em 60,6% dos casos, no proximal em 23,9% e no distal em 15,5%. Noventa e três porcento eram fraturas de traço simples, 4,2% cominutivas e 2,8% segmentares. Lesões associadas foram identificadas em 35,2% dos pacientes. Todas fraturas nos Grupos I e II e 60% daquelas no Grupo III foram tratadas conservadoramente. As complicações observadas até a união óssea foram: discrepância, infecção no trajeto do fio, consolidação viciosa e limitação de movimento do joelho. O tempo médio de consolidação foi 8,6±3,4 semanas, variando com a idade. Concluiu-se que as características das fraturas estudadas foram semelhantes às citadas na literatura e que o tratamento empregado apresentou bom resultado.

Objective: To conduct a descriptive analysis on 31 cases of children with floating elbow who were attended at our clinic between 1994 and 2009, and to review the literature relating to this topic. Methods: Data were obtained through examining the medical records. The following variables were used: age, gender, side, mechanism, type of fracture, classification, treatment and complications. Results: Twentyfour patients (77.4%) were male and seven (22.6%) were female. The mean age was 8.5 (± 3.2) years, ranging from one to 14 years. The left side was predominantly affected (67.7%). The commonest injury mechanism was a fall from a height (74.2%). All the supracondylar fractures were Gartland type III. Distal radius fractures alone, of SalterHarris type II, were diagnosed in 22 patients (71%). Open fractures occurred in 22 cases (71%). Closed reduction and application of a plaster cast for a closed fracture of the distal radius was performed in two patients (6.45%). Simultaneous conservative treatment for two fractures was not used. Sixteen supracondylar fractures (54.8%) were fixed using crossed wires, at 90° to each other, and in 14 cases (45.16%), an intramedullary wire was used together with another wire introduced through the lateral epicondyle at 45°. The following complications were observed: deformed consolidation (10%), nerve injuries (6%), compartment syndrome (3%) and pin path infection (16%). Conclusions: This is an uncommon injury that in most cases results from high-energy trauma. Surgical treatment for both fractures is recommended by most authors. Ulnar nerve injuries were correlated with the fixation method, but no neurological injuries were triggered by the initial trauma.

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