Treatment of Floatin g Knee Injuries

Background: Ipsilateral fractures of the femur and tibia are serious injuries accompanied by injuries to other vital structures as they are usually caused by high-energy trauma. Patients and Methods: Twelve patients with floating knee injuries were treated between January 2003 and January 2006 at the Orthopedic Department-Zagazig University Hospitals, they were 8 males and 4 females. The fractures were classified according to the classification system of Fraser et al.; there were 8 cases of type I, and 4 cases of type II of which 2 cases were of type IIa and 2 cases of type IIb . There were 6 cases with open injuries, 3 cases type I, 1 case type II and 2 cases type IIP according to the classification system of Gustilo. Associated skeletal injuries happened in 6 patients on the same side and in 4 patients on the contra lateral side. Various methods of fixation were used, mainly intramedullary nailing (75%). No vascular injury and only 3 patients had ligamentous injury. Results: The average follow-up period was 18 months (range, 20-24 months). One patient had shortening of 2 centimeters; two patients had limited knee flexion to 100 degrees. No patient needed ligamentous reconstruction and no deep infection. We had 6 patients with excellent results (50%), 3 patients with good results (25%), 3 patients with acceptable results (25%) and no poor results. Conclusion: Early and stable fixation of both femoral and tibial fractures is recommended in patients with floating knee injuries as this reduces systemic and local complications.