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Challenges and outcomes in the treatment of floating knees. A case series of ipsilateral femur and tibia fractures around the knee

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Ipsilateral femur and tibia fractures around the knee (floating knee) are rare injuries that threaten both limb viability and patient life. A correct surgical strategy is essential to reduce complications and sequelae. The aim of this study was to evaluate characteristics and results of treatment in patients with a floating knee treated at a single trauma center.

Material and methods

This is a retrospective and non-consecutive case series of 18 floating knees occurred in 17 patients. All patients were operated in a single third-level public and university hospital from December 2010 to December 2018. Data on demographics, injuries, treatment and follow-up were collected. A general health questionnaire (SF-12) and a knee functional questionnaire (KOOS-PS) were used to display results.

Results

We identified 13 men and 4 women, aged between 16 and 52. Mean follow-up period was 16.49 months. High-energy trauma following a traffic collision was the most frequent mechanism. Mean Injury Severity Score (ISS) was 39.05, and a damage control strategy was used in 15 (83.33%) injuries. Extra-articular fractures (Fraser I) largely predominated, resulting in double intramedullary nailing in 72.22% of cases. Eleven injuries (61.11%) presented with an open fracture. Complications appeared in 6 (33.33%) injuries, being 3 infections. Mean score for the SF-12 was 35.59 for the physical dimension and 50.44 for mental dimension. Mean score for the KOOS-PS was 43.64.

Conclusion

Floating knee injuries usually occur in polytrauma contexts. Visceral involvement and exposed fractures are common, so the most appropriate strategy is usually a staged treatment. Complications and sequelae are frequent.

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Funding

This study had no funding.

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Authors and Affiliations

  1. Orthopaedic Surgery Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Carlos-Alberto Piedra-Calle

  2. Vall D’Hebron Institut de Recerca, Barcelona, Spain

    Yaiza García-Sánchez

  3. Orthopaedic Surgery Department, Orthopaedic Trauma Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Jordi Teixidor-Serra, Jordi Tomás-Hernández, Jordi Selga-Marsá, Juan-Antonio Porcel-Vázquez, Vicente Molero-García & José Vicente Andrés-Peiró

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  1. Carlos-Alberto Piedra-Calle
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  2. Yaiza García-Sánchez
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  3. Jordi Teixidor-Serra
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  4. Jordi Tomás-Hernández
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  5. Jordi Selga-Marsá
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  8. José Vicente Andrés-Peiró
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Correspondence to José Vicente Andrés-Peiró.

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Piedra-Calle, CA., García-Sánchez, Y., Teixidor-Serra, J. et al. Challenges and outcomes in the treatment of floating knees. A case series of ipsilateral femur and tibia fractures around the knee. Eur J Orthop Surg Traumatol 32, 325–331 (2022). https://doi.org/10.1007/s00590-021-02981-7

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  • DOI: https://doi.org/10.1007/s00590-021-02981-7

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