Background:Floating knee is a condition resulting from high energy trauma usually associated with minor to life threatening injuries making it challanging to treat There are no studies available in literature describing cross leg sitting and squatting after surgical management of floating knee. This study analyzes prognostic factors, plan of management, functional outcomes (special attention to squatting and cross legged sitting), complications.Materials and Methods:52 patients with floating knee injuries treated over a period of 3 years were included in this study. The study followed an algorithmic approach for the management. Femur fractures were fixed before fixing the tibia according to fracture type that was classified by Fraser classification after the stabilization of patient. The mean followup duration was 21 ± 6 months. The outcome was assessed using Karlstrom criteria after bony union.Results:The study consists of majority (46) of male. Thirty three patients had some types of significantly associated injury. The mean postoperative range of motion of the knee was observed to be 97° ± 27°. Twenty one patients showed excellent results, whereas 17, 8, and 6 patients had good, fair, and poor results, respectively, as per Karlstrom criteria. Knee pain, stiffness, infection, nerve palsy, delayed union, and nonunion were some of the complications observed. Cross legged sitting was possible in 40 patients and squatting in 31.Conclusion:The prognosis of floating knee injury is dependent on factors such as type of fracture, soft tissue condition, and management. Excellent outcomes following these injuries can be achieved with individualized plan of management by multidisciplinary team.
Introduction:The management of distal humeral fractures has evolved over the last few years. In intra articular fracture of the lower end Humerus the primary goal is to achieve a stable and mobile elbow. Until now, disagreement has existed on how to treat these fractures in elderly patients. Recommendations range from conservative treatment to primary total elbow replacement. So far, reports in the literature on whether or not open reduction and internal fixation in these patients is justified are very rare. Materials and methods: Fifty four patients (Average age 45 years) from Jan 20013 To Dec 2014 were included in this series. There were 38 males and 16 females. Mechanism of injury was fall with back of elbow striking the ground (70%) and Road traffic accident (30%). The author has used AO classification 5 for categorizing the fractures accordingly, 10 fractures were of B2, 14 were B3, 12 were C1 type and 10 belonged to C2 and 8 belonged to C3 Type. Results and discussion: The average follow up was 16 months with a minimum of one year. 14 cases had loss of extension measuring 30 0 and less. Only 12 cases had no loss of extension. Flexion of elbow more than 1200 got recovered in 28 cases. 10 patients had pain in elbow on prolonged activity and changes in weather condition. The final evaluation showed 70 % Excellent and good results, 24% had Fair results and 6% had poor results. When "K' wire alone were used fixation was not stable enough and required longer external immobilization. And delay in start of physiotherapy with consequent loss of movements. Olecranon osteotomy gives better visualization. and reduction of fracture fragments and their articular surface. Conclusion: Rigid AnatomicalFixation & Early Mobilisation is the Key. High complications in Elderly Osteoporotic patients. Younger the patient Better the results. Communition of Fragments show increased Difficulty in Fixation, & results in loss of movements also.
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