Giuseppe Rollo1, Gabriele Falzarano2, Mario Ronga3, Michele Bisaccia4, Predrag Grubor5, Rocco Erasmo6, Guido Rocca7, Felix Tomé-Bermejo8, David Gómez-Garrido8, Paolo Pichierri1, Giuseppe Rinonapoli4, Luigi Meccariello9. 1. Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy. 2. Department of Orthopedics and Traumatology, Azienda Ospedaliera "Gaetano Rummo", Benevento, Italy. 3. Department of Medicine and Health Sciences 'Vincenzo Tiberio' University of Molise, Campobasso, Italy. 4. Department of Orthopedics and Traumatology, Azienda Ospedaliera "Santa Maria della Misericordia", Perugia, Italy. 5. Clinic of Traumatology, University Hospital Clinical Center Banja Luka, Banja Luka, Bosnia and Herzegovina. 6. Department of Orthopedics and Traumatology, Santo Spirito Hospital, Pescara, Italy. 7. Department of Orthopedics and Traumatology, Trauma Center "Pietro Cosma", Camposampiero, PD, Italy. 8. Orthopaedic and Traumatology Unit, Hospital General de Villalba, Madrid, Spain. 9. Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy. Electronic address: drlordmec@gmail.com.
Abstract
INTRODUCTION: Floating knee is a flail knee joint resulting from fractures of the shafts or adjacent metaphyses of the femur and the ipsilateral tibia. It is usually associated with several complications and mortality. This study was designed to present our experience with the treatment of this injury. MATERIAL AND METHOD: This study was performed between January 2004 and December 2014. 224 cases of floating knee injuries gathered from the 34,480 lower extremities trauma files were studied, and the target information recorded. The injuries most frequently occurred in subjects between 16 and 35 years of age (60.71%), and in male subjects (85.71%). The most frequent mechanism of injury was traffic accident (92.85%). External fixation was the common type of treatment (82.14%) in emergency or as a definitive treatment. The treatment was performed within 24 h of the trauma. We performed a 36-month follow up with clinical examination, radiographs, assessing the complications, and using the Modified Cincinnati Rating System Questionnaire (MCRSQ) and the Karlström/Olerud Score (KOS) to evaluate the progression of the outcomes. RESULTS: Early complications included 8 cases of compartment syndrome, 60 open fractures and 24 partially amputated limbs. A total amputation was performed in 3 patients. The most common late complication was heterotopic calcifications of the knee (n = 68, 30.6%). Good scores for MCRSQ and KOS were obtained only after patients were sent to a reference center for knee surgery. CONCLUSIONS: Our experience revealed that the complication rate associated with floatingknee injuries remains high, regardless of the performed treatment. Surgeons should focus on reducing complications while treating these severe injuries.
INTRODUCTION: Floating knee is a flail knee joint resulting from fractures of the shafts or adjacent metaphyses of the femur and the ipsilateral tibia. It is usually associated with several complications and mortality. This study was designed to present our experience with the treatment of this injury. MATERIAL AND METHOD: This study was performed between January 2004 and December 2014. 224 cases of floating knee injuries gathered from the 34,480 lower extremities trauma files were studied, and the target information recorded. The injuries most frequently occurred in subjects between 16 and 35 years of age (60.71%), and in male subjects (85.71%). The most frequent mechanism of injury was traffic accident (92.85%). External fixation was the common type of treatment (82.14%) in emergency or as a definitive treatment. The treatment was performed within 24 h of the trauma. We performed a 36-month follow up with clinical examination, radiographs, assessing the complications, and using the Modified Cincinnati Rating System Questionnaire (MCRSQ) and the Karlström/Olerud Score (KOS) to evaluate the progression of the outcomes. RESULTS: Early complications included 8 cases of compartment syndrome, 60 open fractures and 24 partially amputated limbs. A total amputation was performed in 3 patients. The most common late complication was heterotopic calcifications of the knee (n = 68, 30.6%). Good scores for MCRSQ and KOS were obtained only after patients were sent to a reference center for knee surgery. CONCLUSIONS: Our experience revealed that the complication rate associated with floatingknee injuries remains high, regardless of the performed treatment. Surgeons should focus on reducing complications while treating these severe injuries.
Authors: Octav Marius Russu; Tudor Sorin Pop; Emilian Ciorcila; István Gergely; Sándor-György Zuh; Cristian Trâmbițaș; Paul Gabriel Borodi; Zsuzsanna Incze-Bartha; Andrei Marian Feier; Vlad Alexandru Georgeanu Journal: J Pers Med Date: 2021-05-19