Abstract
To determine the functional outcome of floating knee injury a retrospective study was undertaken at 3 level 1 trauma centers.
Methods: Between 1998 and 2004, 96 consecutive patients were identified with at least 2 years follow up. The average age of the cohort is 31 years (15–74) with 76 males. The average ISS was 17.3 (9–57), 31.3% of the patients were multiply injured (ISS > 18). According Fraser’s classification, 78 patients presented a type I lesion. At least one of the fracture was open in 77% of cases.
Results: The preferred fixation method for the femur was IM nailing, either antegrade (58) or retrograde (14). IM nailing of the tibia was performed in 59 cases. Infection occurred at one site in 14 patients and non union in 25. A multivariate analysis did not show any significant increased risk of non union or different clinical result when using a retrograde nailing technique (single knee incision) except a shorter mean operating time (177’ vs. 132’, p=0.0144) and a shorter mean total surgical procedure (155’ vs. 240’, p< 0.0001). The Karlstrom’s score at the latest follow up was obtained in 86 patients (2–4.5 years) and was rated as good or excellent in 63,4% of cases in type 1 injuries versus 16,7% in type 2.
Conclusion: Floating knee injury remain a rare lesion showing extremely bad prognosis factors in general although clinical results remain closely correlated to intra articular involvement at the fracture site.
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