A STUDY OF FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF IPSILATERAL FEMUR AND TIBIA FRACTURES-FLOATING KNEE INJURIES

Abstract



Context:
Floating knee injury is a term used to denote ipsilateral femoral and tibial metaphyseal injuries. But recent literature has however expanded this term to include most ipsilateral fractures of the femur and tibia.These are extremely heterogeneous groups of injuries. They usually occur due to very high energy trauma. These are relatively uncommon injuries. These are always associated with high morbidity. Most of these injuries result in some permanent disability. There are no specific guidelines for the management. The implant choice needs to be determined depending on nature of fracture and soft tissue injuries. A specific pattern of management can often not be determined.The aim of this study was to analyse the post operative functional outcome of a group of patients sustaining ipsilateral femur and tibia fractures (floating knee injury) using karlstrom and olerud's criteria.
Methods :
Floating knee was classified according to Blake and Mcbryde's Classification. Open fractures were classified according to Gustilo and Anderson classification.A total of 30 patients with ipsilateral femur and tibia fractures were included in the study. They were managed initially by standard trauma protocol and the fractures were managed by various modes of fixation.Data was collected prospectively using a standard proforma and was assessed by karlstoms criteria.
Results:
Type I Blake and Mc Bryde's floating knee injuries were the commonest 15 (50%) cases. The functional outcome was Excellent in four p atients (13.3%), Good in Nine patients (30.0%), Acceptable in Ten Patients (33.3%) and poor in Seven patients (23.3%)
Conclusion:
Floating knee injuries are due to high velocity trauma. Road traffic accidents particularly two wheeler accidents is the commonest cause. Males are affected more. Many are associated with other injuries such as patellar fractures , cruciate ligament injuries and vascular injuries. There are many post operative complications like fat embolism , infection , delayed union and malunion. Poor outcomes are m ainly due to o pen f ractures, communition and intraarticular extensions. Patients who undergo primary nailing will have Excellent or Good results

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