DOI: https://doi.org/10.36347/sjmcr.2026.v14i10.031

Pages: 2250-2255

Introduction. Floating elbow refers to ipsilateral fractures of the humerus and forearm. We report an exceptional pattern combining seven fracture sites and a radial head dislocation. Case presentation. A 68-year-old left-handed man involved in a motorcycle-versus-motorcycle collision sustained, on the left upper limb, a humeral shaft fracture, a trifocal ulna fracture, a bifocal radius fracture with radial head dislocation and an open comminuted fifth metacarpal neck fracture, without neurovascular deficit. Methods. On day 5, in a single anaesthetic session with two successive set-ups: antegrade humeral intramedullary nailing in the beach-chair position, then, in the supine position, distal locking, closed reduction of the radial head under fluoroscopy, radial plating, double ulnar plating, and pinning of the radial styloid, ulnar head and fifth metacarpal. Results. Operative time was 200 minutes and blood loss 400 mL. Reduction of all fracture sites was satisfactory. The early postoperative course was uneventful at day 2. Conclusion. Planned proximal-to-distal segmental fixation allows single-stage treatment of a multifocal floating elbow and early rehabilitation.