Titanium Elastic Nails Research Articles

The Outcome of Titanium Elastic Nail in Pediatric Femoral Diaphyseal Fracture in a Tertiary Care Hospital

Objective: To determine the outcome of titanium elastic nail in pediatric femoral Diaphyseal fracture in a tertiary care hospital. Study Design: A longitudinal study Place and Duration: The Department of Orthopedics, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi from 5th January 2022 to 4th July 2022. Methodology: A total of 126 Patients with femoral shaft fractures who were hospitalized were included. Through a little incision, an intramedullary nail was pushed into the canal. Union and callus formation were monitored with serial radiographs, and weight bearing was gradually increased based on fracture healing. The chi-square test and stratification were utilized to attain this result. A significance level of 0.05 was used. Results: There were 76.2% male and 23.8% female. The mean nail diameter, radiological union, limb length discrepancy and angulation were 3.31±0.32mm, 8.71±1.44weeks, 1.09± 0.81cm and 5.43±2.63° respectively. The mean follow-up was 4.30±1.06 months. The pain was observed in 15.1% of children while in 66.7% of cases no complications were observed. A total of 66.7% of cases were found with excellent, 18.3% with good and 15.1% with poor outcome. Conclusion: Titanium elastic nails have a high probability of good and excellent outcomes in children and it is a simple, minimally invasive implant technique. Keywords: Outcome, Titanium Elastic Nail, Pediatrics, Femoral Diaphyseal Fracture.

A Case Report: Aneurysmal Bone Cyst Of Proximal Femur With Subtrochanteric Femur Fracture In A Child

Aneurysmal bone cysts are blood-filled lesions of the bone that are benign, expansile, aggressive, and locally damaging. They havean atypical presentation and an unknown etiology. We present the case of a 17-year-old male youngster who appeared with a historyof trauma that resulted in a pathological left femur fracture. A subtrochanteric fracture complicated a slowly forming aneurysmalbone cyst in the proximal femur. Excision of the tumor with curettage and open reduction with internal fixation with a titanium elasticnail were successful treatments, and the empty space was replaced with bone graft from the left iliac crest. The gold standard fordiagnosis is a biopsy. Bone grafting should be used in conjunction with fracture fixation to achieve bony union.

Treatment of Diaphyseal Fractures of the Femur in Paediatric Age Group: A Comparative Study of Locking Compression Plate Versus Titanium Elastic Nailing System (TENS).

Background: Diaphyseal femur fractures are commonly seen in the paediatric age group as there is an increase in the incidence of road traffic accidents. Titanium elastic nailing system (TENS) and plating are the common methods used for paediatric long bone fracture fixation. The purpose of our study was to evaluate and compare functional and radiological outcomes of paediatric femur diaphyseal fractures treated with locking compression plates and with TENS.Methods: Our study included 59 patients diagnosed with femur shaft fracture. Twenty-eight patients included in group one underwent open reduction and internal fixation with locking compression plates and 31 patients in group two underwent open reduction/closed reduction with intramedullary TENS. All post-operation patients were evaluated at four, eight, 10, 12, 16, 20, 24, and 36 weeks. The functional outcome was assessed based on the Flynn scoring system and radiological union based on fracture union on X-ray.Results: We analyzed our data using the Flynn scoring system. In group one, out of 28 cases treated with locking compression plates, 25 (89%) were excellent, two (7.5%) were satisfactory, and one (3.5%) was poor. In group two, out of 31 cases treated with intramedullary TENS, 26 (83.8%) were excellent and five (16.2%) were satisfactory. In our study, the average union time in group one was 11.4 weeks and in group two was 14.41 weeks. Fracture union was 100% in both groups.Conclusion: In our study, we noted that the union of the femur shaft was early with the use of locking compression plates. In TENS, there was less intraoperative blood loss, very minimal postoperative scar, and less soft tissue damage. Also, implant removal was easier compared to locking compression plates.

Short Term Clinical, Functional and Radiological of Fixation of Paediatric Femoral Shaft Fracture by Titanium Elastic Nail in Paediatric Patients

Introduction: Femoral shaft fracture is the most common major paediatric orthopaedic. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Elastic stable intramedullary nailing is one for treating these fractures and has a reliable methodology. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. Objective: To evaluate the short term clinical, functional and radiological outcome of intramedullary fixation of displaced femoral shaft fractures in skeletally immature children using titanium elastic nails. Methods: A prospective study was conducted in the Department of Ortho Surgery, National Institute of traumatology and orthopedic rehabilitation (NITOR), Dhaka, Bangladesh from July to December 2020. 52 femoral shaft fractures in child aged 6-14 years were fixed with titanium intramedullary elastic nail in the department of Orthopaedics, NITOR, Bangladesh. Two nails of proper and equal diameter were used for fracture fixation. No external splint was used after surgery. Outcomes assessed on the basis of Flynn et al., scoring criterion. Results: The results of the 52 included in our study. All patients achieved complete healing at a mean of 9.1 (Range 8- 10) weeks. 44 fractures were reduced by closed means but 8 needed open reduction. No major complication was recorded. Most common minor complication was entry site skin irritation recorded in 8 patients. 84.61% had excellent result and 15.38% had satisfactory. Conclusion: The treatment of paediatric shaft femur fracture has been drastically changed over the last two decades to internal fixation by elastically stable intra- medullary nail (ESIN). It allows early ambulation and shorter hospital stay and higher parent satisfaction. It also provides flexural, translational and rotational stability as well.

Management of both bone forearm fracture using titanium elastic nailing system in pediatric age group

Background: The management of pediatric forearm fracture has been a dilemma to surgeon. Conservative treatment with cast still is the preferred treatment. Never the less old children and proximal fracture warrants some form of internal fixation. Aims and Objective: The aims of this were to analyze the role of titanium elastic nailing system in fixation of pediatric forearm fractures and its associated complications. Materials and Methods: Over 3 years, 103 patients were enrolled in our institute. After obtaining consent and preanesthetic check-up, patients were scheduled for surgery, where internal fixation was done using titanium elastic nailing system. Patients were followed up every month for 3 months and then every 3 months interval for 8 months. The time to union and functional score were assessed using modified Flynn score. Results: Among the 103 patients, 63 (61.16%) were in the age group of 7–13 years. Mean age was 11.72±3.50 years (range 4–18 years). Seventy-eight (75.72%) patients were male and fall from height was the most common 66 (64%) mode of injury. Radiological union occurred in most 54 (52.42%) of the patients at average 5–7 weeks. As per the modified Flynn criteria, 82 (79.61%) cases had excellent functional outcome, 11 (10.67%) cases good, 4 (4.12%) fair, and 6 (5.82%) had poor outcome. Neuropraxia was seen in 8 (7.76%) cases and rupture of extensor pollicis brevis was seen in 4 (4.12%) patients and treated accordingly. All the patients regained full functional recovery. Conclusion: TENS is an effective, safe, reliable, and easily reproducible technique for the management of pediatric forearm fractures. It has advantage of preserving the fracture hematoma, providing relative stability to ensue early rehabilitation and minimally invasive nature.

Study of outcome of pediatric shaft of femur fracture treated with Titanium elastic nailing system

Study of outcome of pediatric shaft of femur fracture treated with Titanium elastic nailing system

TITANIUM ELASTIC NAILING SYSTEM IN MID-SHAFT CLAVICLE FRACTURE- A PROSPECTIVE STUDY.

Introduction: Young and active persons are liable for clavicle fractures, most common among Racing individuals ,sports persons and in athletes due to high velocity injury. Clavicle fractures are about 2.5% of all fractures and it is the most common .Satisfactory results with high union rates and less complications have been reported from various techniques for operating Clavicle fractures .The clavicle is a long bone with broad medial and at lateral end and is treated best with Intramedullary elastic devices. So, titanium elastic nailing system is the recommended procedure for all displaced midshaft clavicle fractures to reduce the rate of malunion , non-union, delayed union , symptomatic malunion, and Other complications. Aim Of The Study: To analyze the functional outcome of displaced middle third clavicle Fractures treated by titanium elastic nailing system that will keep the Anatomical shape and length of the clavicle. The study was provisionally approved by the institutionalMaterials And Methods: ethics committee, Andhra medical College, visakhapatnam. This prospective study of displaced midshaft Clavicle fractures treated by titanium elastic nail system was done at the Department of Orthopedics, King George Hospital, Andhra Medical college, Visakhapatnam, from September 2019 to September 2021. Over a period of 2 years with in my academic years from may 2019 to may 2022. Titanium elastic nailingConclusion: system for displaced midshaft clavicle fracture is a safe minimally invasive technique with good functional and radiological outcomes and has better cosmetic appearance . Clavicular fractures which are displaced at middle third are best treated with titanium elastic nailing system with less operative time of 30-45 minutes compared with clavicular plating which takes more than 60-90 minutes. This procedure has better functional outcome than conservative treatment . A good reliable sophisticated minimally invasive technique for midshaft clavicular fractures are xed by Closed nailing or minimal open reduction at fracture site.

Titanium Elastic Nailing System of Diaphyseal Femur Fracture in a 7 Years Old Child: A Case Report

Objective: Midshaft femur fracture commonly treated conservatively in paediatric patients. However, complications are seen in conservative treatments and lately surgical interventions are being practised tremendously to minimise the complications. Case Report: A 7 years old boy, sustained a closed fracture midshaft left femur after a motor vehicle accident. Operative management was decided for this patient using Titanium Elastic Nailing System, which revealed a good outcome within 3 months of duration. Conclusion: Titanium Elastic Nailing System is fixed with minimally invasive techniques in children 6-16 years of age with diaphyseal femoral fractures, which gives a good outcome and minimizes the complications and allows earlier rehabilitation and return to school life by speeding up the fracture healing. However, an experienced surgeon and good surgical technique is desired to minimize the complications that may occur.

Study on outcome of treatment of paediatric femoral shaft fracture by titanium elastic nails

Background: Although the incidence of paediatric femoral shaft fractures is about 1.6%, it’s treatment is controversial, especially in children of age 6-12 years. Materials and Methods: This prospective observational study was performed at Sher E Bangla Medical College Hospital, Barishal, Bangladesh from January 2020 to December 2020, on 7 children (n=7). There were limited number of patients included due to this study accomplished in the perphery city of Bangladesh. Both male and female children with simple transverse and short oblique fractures were included. Results: Among the 7 cases, 6 were closed femoral shaft fracture and 1 was Gustilo Anderson type 1 open fracture. The mean age of the patients was 8.57 years, ranging from 5-13 years. 6 were male and 1 was female, with a male female ratio of 6:1. In 4 cases right side was affected and in 3, left side was affected. 5 cases were treated by closed reduction and the rest 2 cases were treated by open reduction. The average union of fracture was 9.7 (6-15) weeks. Results were evaluated using Flynn et al scoring criteria, with 4 excellent, 2 good and 1 poor outcome during the 5-11 months follow up period. Conclusion: Titanium elastic nailing has considerably decreased the period of immobilization, ensured early return to normal life and provides psychological advantages. It provides better outcome in simple transverse of short oblique mid diaphyseal femoral fractures.

Clinical outcomes of titanium elastic nailing system for middle third clavicular fracture

Aim: Clinical outcome of displaced middle third clavicular fracture using intramedullary fixation by titanium elastic nail. Materials and Methods: 20 cases of displaced middle third clavicular fracture underwent closed reduction internal fixation with Intra medullary fixation by titanium elastic nail. The study was conducted from July 2020 to August 2022 admitted to Narayana Medical College and hospital, Nellore. We evaluated the Constant score to determine the outcomes.Results: All fractures got united in our study. Average time taken for full clinical and radiological union was 11.8 weeks (Range 10- 14 weeks).There were no major complications noted. Average Constant Score at final follow up was 95.16.Conclusion: Minimally invasive fixation with TENS is a safe method and can be performed with minimal complications. This method of fixation of displaced middle third clavicular fractures should result in less soft tissue injury, shorter operating time, satisfactory stabilization, a good cosmetic appearance, quick pain relief, early return to work and easy implant removal under local anaesthesia as an outpatient department procedure.

Functional outcome of dynamic compression plating and intramedullary nailing of diaphyseal fracture of both bones forearm

Background: Excellent results for plate fixation in displaced diaphyseal fractures of both bone of forearm have been reported by various authors, but only a few authors have focused on plate fixation in the management of open diaphyseal fractures of both the radius and ulna. Aim: This present study is aimed to assess the functional outcome of dynamic compression plating and intramedullary nailing of diaphyseal fracture of both bones forearm. Methods: This series consists of 50 cases of fracture both bone of forearm by open reduction and internal fixation with dynamic compression plate, closed reduction with intramedullary nailing by TENS between the period of 2 years at a tertiary care hospital after obtaining the clearance by the hospital ethical committee. Of the above cases 25 patients were treated by open reduction and internal fixation with dynamic compression plate and 25 cases were treated with closed reduction and internal fixation with TENS. Results: Even though, plate osteosynthesis is still the most commonly used form of fixation in adult both bone forearm fractures, both titanium elastic nail and interlocking nail fixation are relatively newer techniques which offer a viable and more efficient alternative especially in fixation of fractures involving shafts of radius and ulna. Conclusions: Increased incidence of forearm fractures was probably due to increasing road traffic accidents and fall. Forearm fractures occurs more commonly in second and third decade. Male predominance was seen. Open reduction and internal fixation can be considered as the treatment of choice if there is no contraindication. It is important to maintain length, opposition, axial alignment, and rotational alignment in order to restore good range of movement of forearm. This is achieved in the present study.

Closed reduction and titanium elastic nailing in diaphyseal femoral and tibial fractures in children

Purpose: The aim of this study was to evaluate clinical and radiological results of children who were treated using titanium elastic nail (TEN) for femoral and tibial diaphyseal fractures.
 Materials and Methods: A total of 49 (15 female, 34 male) femur shaft fractures (FF group) and 35 (12 female, 23 male) tibial shaft fractures (TF group) were retrospectively analyzed. Time until the operation (in days), duration of hospital stays (in days), time to union (in weeks), and the time to implant removal (in months) were recorded. In the final follow up; limb length discrepancy (mm), angulation, restrictions in the range of hip and knee joint motion were measured. Flynn Score was used for clinical results.
 Results: The mean age was 7.96 in the FF group and 9.34 in the TF group. The mean follow-up time was 51.3 months in the FF Group and 58.3 months in the TF group. The mean duration of hospital stay was 1.4 days in both groups. The mean time for bony union was 9.7 weeks and 10.7 weeks for the FF and the TF groups, respectively. The mean time to implant removal was 7.1 months and 6.22 months for the FF and the TF groups, respectively. Flynn scores were poor in 3 patients, successful in 6 patients and excellent in 40 patients in the FF group; whereas it was poor in 1 patient, successful in 2 patients and excellent in 32 patients in the TF group. None of the patients had major complications. Bony union was achieved in all patients. 
 Conclusion: Intramedullary fixation using TEN is a successful treatment method with satisfactory clinical results and low complication rates for pediatric femoral and tibial diaphyseal fractures.

Femoral Shaft Fracture in Post-polio Syndrome Patients: Case Series from a Level-I Trauma Center and Review of Literature.

Femoral shaft fracture in patients of post-polio syndrome (PPS) represents an uncommon yet complex injury pattern. Poorly developed soft-tissue envelope, decreased muscle bulk, reduced vascularity, regional osteopenia, joint contractures, and altered bony anatomy impose significant surgical challenges. Thorough pre-operative planning is imperative as each case requires individualized approach and method of fixation. The aim of the study was to analyze the clinical outcomes in such patients following fracture fixation and to assess the surgical challenges encountered and provide solutions. A retrospective case series of 33 patients with femoral shaft fracture in PPS limbs was undertaken. Mode of injury, method of fixation, surgical time, intra-operative blood loss, union time, and complications were recorded. Low-energy fall was the most common mechanism of injury (73%). Thirty-three patients underwent fixation with intramedullary nailing being the most common mode (79%). Femoral canal diameter, femoral bow, fracture location and morphology and clinical deformities of the patients are key governing factors that determine the choice of implant. Locking plates, pre-contoured anatomical plates, and titanium elastic nailing system offer an alternative in patients unsuitable for nailing. With no difference between various implants, average time for bone healing was 13.8 ± 4.4weeks. All patients resumed full weight-bearing mobilization and returned to pre-injury activity status at the end of 6months post-surgery. With detailed pre-operative work-up, contemplating intra-operative difficulties, individualized surgical plan, careful handling of soft tissues, and availability of back-up implants, good clinical outcomes can be achieved in femur fractures in PPS patients.

Titanium elastic nail for infected humerus fracture with wrist drop: a rare case report

<p class="abstract">Humerus mid-shaft fractures are typically managed with ORIF and plate fixation but a rare attempt for CRIF with titanium elastic nail (TENS) nail done even with infection <em>in situ</em>. A 28 year old male, a daily wage worker presented to us with mid-shaft humerus fracture with wrist drop after an incident of fall while carrying heavy load on his head. On X-ray evidence of osteolysis at the fracture site was found and following bone biopsy infected foci was discovered. Later, managed with CRIF with TENS nail and antibiotics. CRIF for infected long bone fracture is rare, but a bold attempt was made for internal fixation which yielded good results and post-operative 3 months showed great results with full active range of motion without any infective foci and with recovery of wirst range of motion.</p>

Functional outcome of elastic intramedullary nailing for femoral shaft fractures in children

Background: Pediatric femoral shaft fracture is the most frequent fracture type in orthopedic practice in which males are affected more commonly than females. Currently, intramedullary fixation for the managing of femoral shaft fracture in children is widely used worldwide, including Iraq, which overcomes most of the difficulties related to other treatment modalities. Objectives: This study aimed to determine the clinical, functional, and radiological consequences of pediatric femoral shaft fractures achieved with a titanium elastic nail system (TENS). Materials & Methods: In this study, 28 children aged 5-10 years with femoral shaft fracture admitted to Shar Hospital, Sulaimaniyah, Republic of Iraq, were enrolled. Their fractures were fixed with Titanium Elastic Nail (TEN), in which a pair of the same-sized nail was used for each fracture. The outcomes were assessed using Flynn’s scoring criteria. Finally, the patients were discharged the next day and followed up after 2, 4, 8, 12 and 20 weeks of surgery. Results: Based on Flynn’s score assessment, the outcome of 85.71% of patients were excellent, 12.5% were satisfactory, and 1.79% were poor. All patients were showed a radiological unification and a conceivable full weight-bearing in a mean time of ~ 9 weeks, while their full knee variety of movement was attained in 2 months. Conclusions: TENS is a potential means to treat femoral shaft fractures in children as it is a simple, safe, minimally invasive, and physeal-protective with fewer complications and a high rate of good and excellent outcomes.

Minimally invasive plate osteosynthesis for clavicle shaft fractures

Abstract Objective Whereas open reduction and internal fixation remains the surgical standard for displaced clavicle shaft fractures, the minimally invasive plate osteosynthesis (MIPO) technique has been introduced for multifragmentary, non-antomically reducible fractures, and unstable fractures with significant soft tissue injuries. Its advantages lie in the preservation of the vascular supply of the fracture zone and the preservation of the supraclavicular nerve. The aim of this study was to prove feasibility and share our experiences with this technique. Methods In this single center retrospective case series, we analyzed all patients that underwent MIPO for displaced clavicular shaft fractures from 2001–2021. Patient history, fracture morphology and perioperative data were documented. Outcomes were assessed based on clinical and radiographic follow-up reports. Results In total, 1128 clavicle osteosyntheses were performed, of which 908 (80.5%) were treated with a plate and 220 (19.5%) with titanium elastic nail (TEN). Of the 908 plate osteosyntheses, 43 (4.7%) were performed with the MIPO approach. Mean age was 44 ± 15 years, 83.3% were males and 79.1% were sports injuries. The fractures were categorized as AO/OTA type C injuries (n=26) in most patients, followed by A (n=9) and B (n=8). Two open (Gustilo I) and 41 closed fractures were noted (Tscherne 0=26; I=13, II=2). In seven patients (16.7%), the clavicle fractures were part of a severe polytrauma. Concomitant serial rib fractures and scapular fractures were found in 19 (45.2%) and 10 patients (23.8%), respectively. Length of surgery was 63 ± 28 min, and hospitalization was 4 ± 3 days (excl. polytraumas). 27 of the 43 fractures (62.8%) were clinically and radiographically followed up in our outpatient clinic, of which 26 (96.3%) healed with noticeable callus formation. In one case, a pseudoarthrosis was found two years after fracture treatment. Otherwise, all patients followed a remarkable postoperative course, were pain-free and able to return to work, most within five weeks. Conclusion In this retrospective analysis, 96.3% of the clavicle shaft fractures treated with MIPO healed in a timely manner. The MIPO technique is feasible and plausibly advantageous for distinct fracture and injury patterns (i.e. multifragmentary fractures or unstable fractures with soft tissue injuries). Future comparative studies are warranted to clarify our observations.

Evaluation of functional outcome of forearm fracture in children treated with elastic nail (TENs)

Background: Forearm fractures are one of the most common injuries sustained by children and both bone forearm fractures are estimated around 40% of all pediatric fractures. Pediatric forearm fractures occur in approximately 1 in 100 children per year. Forearm shaft fractures in children are usually treated with closed reduction and cast immobilization and a good functional outcome is obtained, but few patients with gross displacement, angulations, soft tissue swelling due to edema, children nearing skeletal maturity, proximal third fractures, open fractures and displacement after closed manipulation and cast immobilization require surgical intervention. Greater controversy exists regarding the optimal method of fixation in children. Fractures in this age group that cannot be maintained in acceptable alignment with closed reduction can be treated with either intramedullary nails or open reduction and internal fixation with plates. The purpose of this study was to investigate the indications, techniques, clinical results, functional outcomes, possible complications and means of avoiding them in unstable forearm fractures in children treated with titanium elastic nails (TENs). Methods: Our prospective interventional study included Forty five children after application of inclusion and exclusion criteria, consent for study was taken from the parents.

Operative Fixation of Displaced Midclavicular Fractures in Adult by Titanium Elastic Nailing System

Introduction and aim: Clavicular fractures are very common, and it usually treated conservatively. However, recent shift to surgical intervention had been observed. The guidelines seem to be in its road to change. The aim of this work is to asses clinical and radiological results of surgical fixation of midshaft clavicle fractures by Titanium Elastic Nailing System.
 Methodology: Fifteen patients with mid-shaft (middle third) displaced fractures of the clavicle were included. All were assessed in systematic manner (history, examination and investigations). Then, eligible patients provided an informed consent and underwent surgical treatment according to study protocol. All were followed up for 6 months and their outcome was ranged according to Constant and Murley Score.
 Results: Ten patients (66.7%) had excellent, 3 patients (20%) had good, one patient (6.7%) had fair, and one patient (6.7%) had poor outcome. Pain was absent or mild in the majority of patients (93.3%). 86.7% of patients return to full work, and all had unaffected sleep. Union was achieved in 14 patients (93.3%). One patient had an infection, two had medial end skin irritation and one had hypertrophic non-union. Younger age and absence of any associated medical disease were associated with excellent outcome.
 Conclusion: Titanium Elastic Nailing could be considered as a reasonable alternative approach to the management of displaced mid-shaft clavicular fractures, as it is associated with excellent outcome, low pain, and early return to normal daily activities.

Closed reduction and internal fixation with titanium elastic nailing system in pediatric both-bone forearm fractures

<p class="abstract"><strong>Background:</strong> The present study is designed to analyse the postoperative clinical and functional outcome of closed reduction and internal fixation of pediatric both-bone forearm fractures with titanium elastic nailing system (TENS).</p><p class="abstract"><strong>Methods:</strong> A total of 32 patients in the age group of 5 to 15 years with fracture both-bone forearm underwent closed reduction and internal fixation with TENS at our hospital. Patients with displaced fractures having angulation more than 10° and rotation of more than 45° or fractures with unacceptable reduction post conservative management were included in this study. For functional outcome, upper extremity rating scale (UERS) was used to evaluate the range of motion and grip strength.<strong></strong></p><p class="abstract"><strong>Results:</strong> Patients were followed up for a period of 6 months. In all cases fracture united in the range of 6-14 weeks without any malunion. All 32 cases had excellent outcomes according to UERS score. Two patients had deficient forearm pronation of 10° and 15° respectively. Skin irritation and implant impingement was seen in two patients each at final follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Closed reduction and internal fixation with TENS seems to be a good treatment option for fixation of pediatric both bone forearm fractures. It gives excellent functional outcome in terms of range of motion and grip strength without any major complications.</p>

A rare paediatric 'floating elbow'; a supracondylar fracture with an ipsilateral Monteggia fracture: A case report.

Introduction and importanceA paediatric floating elbow involves fractures of the supracondylar region of the humerus with ipsilateral fracture of the forearm bones. A floating elbow is very uncommon with an incidence of 3 to 13% of all supracondylar fractures. A concomitant supracondylar and Monteggia fracture is extremely rare with only six cases reported in the literature.Case presentationWe present the unusual case of an eight-year-old girl with a concomitant ipsilateral supracondylar humerus fracture and open Monteggia fracture. Physical examination showed a neurovascularly intact limb. Surgical management was carried out in the form of closed and open reduction, percutaneous pinning using Kirschner (K) wires and Titanium Elastic Nails (TENs), and wound washout and debridement of the open lesion.The patient developed pin site infection six weeks post operation and subsequently underwent surgery for removal of pins. She was later followed up with normal radiographic and physical examination findings.Clinical discussionThe complexity of these fractures can lead to debilitating complications if proper management is not initiated. It is imperative that neurovascular and motor function be assessed in great detail and early surgical fixation be carried out in order to prevent these complications.ConclusionA paediatric floating elbow is a rare surgical emergency. Although no guidelines for the management of these fractures exist, we recommend surgical management in a step-by-step approach be used over conservative management. We also stress the importance of regular follow up to address any post operative complications that may arise such as the one in our case.