An Approach to Floating Knee Injury in Indian Population

Abstract

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.

Floating knee injuries - An Analysis of Outcome in Surgically Treated Patients in a Tertiary Care Institution

“…Studies reported mortality rate between 5% and 15% in patients with floating knee injuries which reflects the impact of associated injuries, 15 whereas in our study no mortality was reported. Goel et all in his study mentioned that left limb was more commonly involved than the right, another study done by Chavda AG et al showed right limb more commonly involved, 2,14 whereas in our study we found left limb to be more commonly involved, but the mechanism for limb preference in floating knee injuries was not explained in literature.…”

“…In a recent study by Kao et al on floating knee injuries observed 26% were associated with head injury and 9% with abdominal or chest trauma and a similar study done in Gujarat by Chavda AG et al found 15% associated with head injury followed by 10% with chest trauma and 5% with abdominal injury. 13,14 Similarly in our study we found head injury is the most commonly associated injury which was seen in 12.5% of the subjects followed by and abdominal injuries which was seen in 8% of the patients with floating knee injuries. Studies reported mortality rate between 5% and 15% in patients with floating knee injuries which reflects the impact of associated injuries, 15 whereas in our study no mortality was reported.…”

Comparative Analysis of Open and Closed Floating Knee Injuries

“…Patients' follow-ups averaged 28 (14-70) months. Our comparison of hospital stay length between showed a mean length of 13.17 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) days in Group 1 and of 9.75 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14) days in Group 2. Length of stay showed a statistically significant difference between groups (p = 0.01).…”

“…Similar studies support the good outcomes of closed fractures. ( 12 Kulkarni et al ( 13 found that floating knee injuries suffer the influence of open or closed fractures, segmental nature, additional injuries, and intraarticular surfaces. Our study ignored floating knee injuries with segmental fractures.…”

Advances in Understanding and Managing Floating Knee Injuries: A Comprehensive Review

“…Treatment typically involves immobilization with a brace or cast, nonweight-bearing or partial weight-bearing, and early mobilization as tolerated. Physical therapy and rehabilitation exercises are initiated to improve the range of motion, strengthen muscles, and facilitate functional recovery [35]. Close monitoring of clinical progress and serial imaging studies may be warranted to assess fracture healing and ensure the stability of the knee joint.…”