Challenges and outcomes in the treatment of floating knees. A case series of ipsilateral femur and tibia fractures around the knee

Piedra-Calle, Carlos-Alberto; García-Sánchez, Yaiza; Teixidor-Serra, Jordi; Tomàs-Hernández, Jordi; Selga-Marsà, Jordi; Vázquez, Juan Antonio Porcel; Molero-García, Vicente; Andrés-Peiró, José Vicente

doi:10.1007/s00590-021-02981-7

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…The mean ISS was 24.80 ± 8.48; a value slightly higher than that reported by Piétu et al ( 22 ). However, this remains lower than the report from another scholar who reported a mean ISS as high as 39.05 ( 3 ). This could simply reflect the severity of the floating knee with associated injuries in a context where disregard for road safety, non-compliance with the Highway Code, and speeding are common.…”

Section: Discussioncontrasting

confidence: 69%

“…It is associated with high-energy trauma and is accompanied by other associated injuries as well as soft tissue lesions (ligaments and meniscus injury) ( 2 , 4 – 6 ). There is limited data estimating the prevalence of this atypical injury among the population, however, there is a tendency with male predominance ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…The term was initially used in early 1975 by Blake and Mc Bryde to describe fractures of the ipsilateral femur and tibia (1). Although fracture to either femur or tibia is very common in trauma, the occurrence of both simultaneously in the same limb (ipsilateral) is unusual (1,3). It is associated with high-energy trauma and is accompanied by other associated injuries as well as soft tissue lesions (ligaments and meniscus injury) (2,(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…Other authors have also proposed a treatment algorithm for floating knees based on patient/limb condition, and Fraser's classification system. However, it is prudent to adapt the treatment plan to the skin, soft tissue damage, joint articular surface involvement, and the degree of comminution of the fracture fragment which represents the best postoperative functional prognosis and also best minimizes complications (3,9,14) including infection, nonunion, mal-union, and joint stiffness (15) each of which may lead to functional impairment and unsatisfactory results. This article will discuss incidence of floating knee injuries in lower limb trauma, the challenges in its management, and factors affecting the clinical outcome.…”

Section: Introductionmentioning

confidence: 99%

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The current issues and challenges in the management of floating knee injury: a retrospective study

et al. 2023

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PurposeThe management of floating knee injuries is still controversial and challenging for trauma specialists. This study aims to evaluate the incidence of the floating knee in lower limb trauma, analyzing the challenges in its management, and factors affecting clinical outcomes.MethodsIn this mono-center retrospective study, 36 consecutive patients were included. All individuals were diagnosed with an ipsilateral fracture of the femur and tibia, managed surgically according to their fracture pattern (Fraser classification), and the severity of the injury. The timing for each operation was determined based on the general condition of the patient and the local physiological condition of soft tissues. The patients’ clinical outcomes were finally evaluated based on their Karlstrom and Olerud scores and were categorized as excellent, good, acceptable, fair, or poor.ResultsIn this study, the mean follow-up period was 51.39 ± 16.02 months (11–130 months). Incidence of the floating knee was 2.32% in all lower limb traumas. From this number, 16 patients suffered from floating knee injury in the left lower extremity, and 18 in the right lower limb, while in 2 patients the condition was bilateral. The most common injury mechanism was road traffic accidents, accounting for 28 (77.78%) cases. The outcome was as follows; Excellent to good results in 22 (61.11%) cases, acceptable results in 2 (5.56%) cases, and fair to poor results in 12 (33.33%) cases according to the Karlström–Olerud scoring system. The most frequent early complications were wound infection and deep venous thrombosis in 5 (13.88%) of the cases. The most common late complication was common peroneal nerve palsy recorded in 2 (5.56%) cases.ConclusionThe presence of important concomitant injuries to the floating knee together with poor soft tissue conditions constituted important factors influencing possible management options and may have led to poorer clinical outcomes.

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Section: Discussioncontrasting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The current issues and challenges in the management of floating knee injury: a retrospective study

et al. 2023

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Simultaneous ipsilateral floating hip and knee: the double floating extremity—a systematic review and proposal of a treatment algorithm

Giordano,

Miura,

Calegari

et al. 2023

Eur J Trauma Emerg Surg

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Ipsilateral injuries of the lower extremity in patients with polytrauma. Message 1

Tanasienko,

Eusypenko

2024

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation. Among the causes of unsatisfactory results in the treatment of patients with polytrauma and ipsilateral fractures of the lower extremities, many authors consider the severity of injuries, the ineffectiveness of conservative treatment methods, the frequent development of complications of both an infectious and non-infectious nature when performing osteosynthesis. The aim of our study was to determine the causes and mechanism of injury in patients with ipsilateral lower limb injuries and polytrauma. 67 patients in whom ipsilateral hip and tibia fractures with polytrauma were verified took part in our study. This cohort of patients was treated at the Odesa City Clinical Hospital № 11 from 2010 to 2020. The first group included 44 patients, the second group included 23 patients who met the criteria for inclusion in our study and whose treatment ended in death. Statistical processing was carried out using a non-parametric method, the coefficient of the K. Pearson polychoric correlation index was calculated. It was found that, most often, ipsilateral hip and lower leg fractures occur in patients with polytrauma aged 30-45 years, which was found in 36.4% of cases in the first group and 43.5% of cases in the second group. The main causes of polytrauma in the patients of our study were road accidents, which were found in 74.6% of cases. Catatrauma as a cause of ipsilateral damage to the lower limb and polytrauma was found in 21.2% of patients of the main massif. In the traumatogenesis of damage among the patients of the research array, a direct blow prevailed, which was found in almost all patients participating in the study. Thus, it is worth noting that in our study, it was found that ipsilateral fractures of the lower extremities in patients with polytrauma occur as a result of high-energy trauma. Conclusions: The problem of ipsilateral injuries of the lower extremities in polytrauma requires further research to reduce mortality among this category of patients.

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Challenges and outcomes in the treatment of floating knees. A case series of ipsilateral femur and tibia fractures around the knee

Cited by 3 publications

References 18 publications

The current issues and challenges in the management of floating knee injury: a retrospective study

The current issues and challenges in the management of floating knee injury: a retrospective study

Simultaneous ipsilateral floating hip and knee: the double floating extremity—a systematic review and proposal of a treatment algorithm

Ipsilateral injuries of the lower extremity in patients with polytrauma. Message 1

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