J Korean Fract Soc.  2012 Oct;25(4):277-282. 10.12671/jkfs.2012.25.4.277.

Comparison of Floating Knee according to Presence of Knee Joint Injury

• Chung ES
• Park JH
• Choi HR
• Lee JH
• Lee KB

• KMID: 1434066
• DOI: http://doi.org/10.12671/jkfs.2012.25.4.277

Abstract

PURPOSE
To compare the clinical outcomes of floating knee according to the presence of knee joint injury.
MATERIALS AND METHODS
Between March 2004 and March 2009, we investigated 36 patients, who underwent surgical treatment for floating knee injuries. We classified the floating knee into two groups as type I (12 cases) has no knee joint injury and type II (24 cases) has knee joint injury. We compared two groups about combined injury (orthopedics or other part), open fracture or not, neurovascular injury,union time, range of motion, and complication rate.
RESULTS
There is statistically no significant difference between two groups as type I (6 cases, 50%) and type II (13 cases, 54.2%) in orthopedic combined injury (p=0.813), and also same as type I (3 cases, 25%) and type II (12 cases, 50%) in combined injury on the other department (p=0.151), and in floating knee with open fracture as 4 type I (33%) and 12 type II (50%) of 16 cases (44%), and Gustilo-Anderson 3 type I, 4 type II, 1 IIIA, 4 IIIB, and 4 IIIC (p=0.423). There is statistically no significant difference between two groups in neurovascular injury as 1 type I (8.3%), and 3 type II (12.5%) (p=0.708). There is a statistically significant difference between two groups in the mean bone union time as 18.2+/-5.37 weeks (12~24 weeks) for type I and 24.95+/-9.85 weeks (16~33 weeks) for type II (p=0.045), and in the mean range of knee joint motion as 133+/-12.74 degree (120~150 degree) for type I and 105+/-19.00 degree (80~135 degree) for type II (p=0.012).
CONCLUSION
Floating knee with knee joint injury is severe itself and related with severe combined injuries, subsequent range of knee joint motion limitation, the delay of union time, and high complication rate. Therefore, we should take care in surgical treatment for this trauma entity.

Keyword

Knee joint; Femur; Floating knee

MeSH Terms

Femur
Fractures, Open
Humans
Knee
Knee Injuries
Knee Joint
Orthopedics
Range of Motion, Articular

Figure

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  Fig. 1 (A) Preoperative knee anteroposterior (AP) lateral radiographs show a tibia and femur shaft comminuted fracture, but the fracture line does not extend to the knee joint. (B) Postoperative knee AP lateral radiographs show good reduction with internal fixation device (intramedullary nails). (C) Last follow-up knee AP lateral radiographs show the complete bony healing at fracture sites.

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  Fig. 2 (A) Preoperative knee antero-posterior (AP) lateral radiographs show femur intra-articular comminuted fracture and tibia open comminuted fracture with posterior tibial artery rupture. (B) Postoperative femur and tibia AP lateral radiographs show plate and screw fixation for the femur and temporary external fixation for the tibia, which was converted to plate and screw fixation after open wound healing. (C) Last follow-up knee AP lateral radiographs show complete bony healing at the fracture sites.

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