TITLE:
Traumatic Floating Bone. About 11 Cases and a Literature Review
AUTHORS:
Amadou Ndiassé Kasse, Malick Diallo, Souleymane Diao, Jean Claude Sane, Abdoulaye Bousso, Abdou Razack Ndiaye, Mouhamadou Habib SY
KEYWORDS:
Traumatic Dislocation, Floating Bone, Bipolar Dislocation, Clavicle, First Metatarsal, Forearm, First Metacarpal, First Phalanx, Femur
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.7 No.12,
November
30,
2017
ABSTRACT: Introduction: Floating bone injury or
bipolar dislocation is a concurrent dislocation at both ends of a long bone or
a flat bone. It is an exceptional injury. We report 11 consecutives cases of floating
bones. Objectives: The aim of the study is to analyze the frequency, the
mechanism of injury and clinical forms of floating bones, and to present the
results of their management. Material and Methods: A ten years ongoing
retrospective study was held in four trauma departments. Eleven cases of
floating bones were identified. The floating bones characteristics such as the
injured bone, the patient age and sex, the mechanism of injury, the dislocations
directions, the associated complications, the treatment and the outcome were
studied. Results: Nine male and two female patients, with a mean age of
37 years [19 - 65 years range] presented a concurrent bipolar
dislocation of one bone or a group of bones. They sustained a road traffic accident (n = 5), a
workplace accident (n = 3), a fall from height (n = 2), and a sport accident (n
= 1). The clavicle (n = 3) and the first metatarsal (n = 3) were the most
frequently involved. The others floating bones were the radius-ulna complex (n
= 1), the radius-lunatum complex (n = 1), the first metacarpal (n = 1), the
first phalanx (n = 1) and the femur (n = 1). The floating bones ends
displacement occurred in the sagittal plane (the forearm, the femur, the first
phalanx and the first metatarsal) and in the horizontal plane (the clavicle,
the first metatarsal and the first metacarpal). We defined direction
displacements as bidirectional asymmetric (n = 10) or unidirectional symmetric
(n = 1). Associated complications were fractures (wrist, hip, tarso-metatarsal
joints) and wounds (fingers, metatarso-phalangeal joint). Dislocations were
treated conservatively (n = 5) and surgically (n = 17) with excellent results
(n = 13/16 joints). Three patients were lost
of view. Conclusion: Our study described the characteristics of
this exceptional injury. For any joint dislocation, we promote the systematic
examination of the other end of the dislocated bone.