Abstract
One hundred twenty-four consecutive patients with true floating knee injury presented between 1987 and 2001. They were treated with non-operative, operative (external fixation and intramedullary nailing) and combined modalities. Sixty patients were followed up, at an average of 7.2 years, for age, gender, type of trauma and fracture; time to fracture union and time to mobilisation. Complications that were encountered and return to normal activities were recorded. Better and comparable union rates of fractures, earlier return to activities and higher excellent and good long-term functional results were observed among combined and operative (intramedullary nail) groups. Using combined modalities of treatment is an affordable, practicable and effective approach, especially for a resource-poor environment. External fixation of the fractured femur resulted in a decreased range of movement at the knee due to quadriceps muscle fixation. Fractured tibia, treated by any of the method, did not interfere with patient’s joint mobilisation whereas associated injuries did.
Résumé
Cent vingt-quatre malades consécutifs ont présenté un genou flottant traumatique entre 1987 et 2001. Ils ont été traités avec une méthode non—opératoire, une méthode opératoire (fixation externe et enclouage centromédullaire) et une méthode à modalités combinées. Soixante malades ont été suivis pendant une moyenne de 7,2 années en notant l’âge, le genre, le type de trauma et de fracture, la durée de consolidation osseuse, le délai de début de mobilisation, les complications rencontrées et le retour aux activités normales. Parmi les groupes combinés et opératoires (enclouage centromédullaire) ont été observés une meilleure vitesse de consolidation des fractures , une reprise d’activité plus rapide et plus de bons ou très bons résultats fonctionnels. La modalité combinée est une approche accessible et efficace pour un environnement aux ressources limitées. La fixation externe du fémur fracturé a entrainé une diminution de la mobilité du genou à cause de la fixation du quadriceps. La fracture du tibia, quelque soit son traitement, n’interfère pas avec la mobilisation articulaire à la différence des lésions associées
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adamson GJ, Wiss DA, Lowery GL, Peters CL (1992) Type II floating knee: ipsilateral femoral and tibial fractures with intraarticular extension into the knee joint. J Orthop Trauma 6:333–339
Anastopoulos G, Assimakopoulos A, Exarchou E, Pantazopoulos T (1992) Ipsilateral fractures of the femur and tibia. Injury 23:439–441
Bansal VP, Singhal V, Mam MK, Gill SS (1984) The floating knee, 40 cases of ipsilateral fractures of the femur and the tibia. Int Orthop 8:183–187
Behr JT, Apel DM, Pinzur MS, Dobozi WR, Behr MJ (1987) Flexible intramedullary nails for ipsilateral femoral and tibial fractures. J Trauma 27:1354–1357
Blake R, McBryde A Jr (1975) The floating knee: ipsilateral fractures of the tibia and femur. South Med J 68:13–16
Fraser RD, Hunter GA, Waddell JP (1978) Ipsilateral fracture of the femur and tibia. J Bone Joint Surg Br 60:510–515
Gregory P, DiCicco J, Karpik K, DiPasquale T, Herscovici D, Sanders R (1996) Ipsilateral fractures of the femur and tibia: treatment with retrograde femoral nailing and unreamed tibial nailing. J Orthop Trauma 10:309–316
Gustilo RB, Anderson JT (1976) Prevention of infection in treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 58:453–458
Gustilo RB, Mendoza RM, Williams DN (1984) Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma 24:742–746
Hee HT, Wong HP, Low YP, Myers L (2001) Predictors of outcome of floating knee injuries in adults: 89 patients followed for 2–12 years. Acta Orthop Scand 72:385–394
Hojer H, Gillquist J, Liljedahl SO (1977) Combined fractures of the femoral and tibial shafts in the same limb. Injury 8:206–212
Karlstrom G, Olerud S (1977) Ipsilateral fractures of femur and tibia. J Bone Joint Surg Am 59:240–243
Lundy DW, Johnson KD (2001) Floating knee injuries: ipsilateral fractures of the femur and tibia. J Am Acad Orthop Surg 9:238–245
Paul GR, Sawka MW, Whitelaw GP (1990) Fractures of the ipsilateral femur and tibia: emphasis on intra-articular and soft tissue injury. J Orthop Trauma 4:309–314
Rooser B, Hansson P (1985) External fixation of ipsilateral fractures of the femur and tibia. Injury 16:371–373
Veith RG, Winquist RA, Hansen ST Jr (1984) Ipsilateral fractures of the femur and tibia. A report of fifty-seven consecutive cases. J Bone Joint Surg Am 66:991–1002
Yokoyama K, Tsukamoto T, Aoki S, Wakita R, Uchino M, Noumi T, Fukushima N, Itoman M (2002) Evaluation of functional outcome of the floating knee injury using multivariate analysis. Arch Orthop Trauma Surg 122:432–435
Author information
Authors and Affiliations
Corresponding author
Additional information
No financial grant or support was taken from any source for this study.
Rights and permissions
About this article
Cite this article
Dwyer, A.J., Paul, R., Mam, M.K. et al. Floating knee injuries: long-term results of four treatment methods. International Orthopaedics (SICOT) 29, 314–318 (2005). https://doi.org/10.1007/s00264-005-0679-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-005-0679-x