Abstract
There is a high incidence of ipsilateral knee injuries with the Floating knee, which makes these fractures even more challenging to manage. We present the impact knee injuries have on the final outcome of the floating knee. We propose a protocol for assessment & management of knee injuries with the Floating knee.
This prospective study included 29 patients with floating knee injuries. Knee injuries encountered were divided into bony, ligamentous and soft tissue. Bony injuries were assessed with radiographs and managed surgically along with the floating knee injury. Patients were assessed clinically for knee ligament injuries after fixation of the fractures intra-operatively and managed surgically. Soft tissue injuries around the knee were managed conservatively. Final outcome was assessed using the Karlstrom criteria.
Ten of the 29 patients had knee injuries: 3 patella fractures, 2 anterior cruciate ligament injuries, 1 posterior cruciate ligament injury, 1 medial meniscus injury and 3 extensive soft tissue injuries. The complications were knee stiffness and superficial infection. The end results according to the Karlstrom criteria were Good – 6, Acceptable – 1 and Poor – 3.
The associated knee injury in the floating knee is an important prognostic indicator. Soft tissue injury seems to have a very poor prognosis. We propose clinical evaluation of the knee after fixation of the fractures, surgical management of ligament & bony injuries and a proper rehabilitation programme to improve outcomes.
Correspondence should be addressed to Editorial Secretary Mr ML Costa or Assistant Editorial Secretary Mr B.J. Ollivere at BOA, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England; Email: mattcosta@hotmail.com or ben@ollivere.co.uk
