Research

The floating knee: epidemiology, prognostic indicators & outcome following surgical management

Ulfin Rethnam^1,4 , Rajam S Yesupalan² and Rajagopalan Nair³

¹  Department of Orthopaedics, Glan Clwyd Hospital, Bodelwyddan, UK

²  Department of Orthopaedics, Glan Clwyd Hospital, Bodelwyddan, UK

³  Department of Orthopaedics, St John's medical college, Bangalore, India

⁴  11 Ffordd Parc Castell, Bodelwyddan, Rhyl, LL18 5WD, UK

author email corresponding author email

Journal of Trauma Management & Outcomes 2007, 1:2doi:10.1186/1752-2897-1-2

Published:	26 November 2007

Abstract

Background

Floating Knee injuries are complex injuries. The type of fractures, soft tissue and associated injuries make this a challenging problem to manage. We present the outcome of these injuries after surgical management.

Methods

29 patients with floating knee injuries were managed over a 3 year period. This was a prospective study were both fractures of the floating knee injury were surgically fixed using different modalities. The associated injuries were managed appropriately. Assessment of the end result was done by the Karlstrom criteria after bony union.

Results

The mechanism of injury was road traffic accident in 27/29 patients. There were 38 associated injuries. 20/29 patients had intramedullary nailing for both fractures. The complications were knee stiffness, foot drop, delayed union of tibia and superficial infection. The bony union time ranged from 15 – 22.5 weeks for femur fractures and 17 – 28 weeks for the tibia. According to the Karlstrom criteria the end results were Excellent – 15, Good – 11, Acceptable – 1 and Poor – 3.

Conclusion

The associated injuries and the type of fracture (open, intra-articular, comminution) are prognostic indicators in the Floating knee. Appropriate management of the associated injuries, intramedullary nailing of both the fractures and post operative rehabilitation are necessary for good final outcome.