Adamson G J, Wiss D A, Lowery G L, Peters C L
Department of Orthopedic Surgery, Los Angeles County Hospital, University of Southern California.
J Orthop Trauma. 1992;6(3):333-9.
Thirty-four patients with ipsilateral fractures of the femur and tibia with intraarticular extension into the knee of at least one fracture were reviewed at an average follow-up of 38 months. Joint involvement was present in 22 (65%) femoral fractures and 23 (68%) tibial fractures. In 11 (32%) patients, both fractures were intraarticular. In 71% of the patients, there were major associated injuries. Open fractures were common, occurring in 21 (62%) extremities. Associated vascular injuries were seen in seven (21%) cases. Ninety percent of the fractures were surgically stabilized. The average time to healing was 39 and 37.5 weeks for the femur and tibia, respectively. The average flexion of the knee was 96 degrees (5-140 degrees) with flexion contractures occurring in five (15%) knees. Results were graded according to criteria established by Karlström and Olerud. Only eight (24%) patients had good or excellent results. Complications were frequent, with deep infections occurring in 11 (32%) extremities, leading to above-knee amputations in three (9%) patients. This subgroup of floating knee injuries appears to be associated with a higher degree of systemic trauma, a higher percentage of open injuries, and a much graver prognosis.
对34例同侧股骨和胫骨骨折且至少有一处骨折关节内延伸至膝关节的患者进行了回顾性研究，平均随访38个月。22例（65%）股骨骨折和23例（68%）胫骨骨折有关节受累。11例（32%）患者两处骨折均为关节内骨折。71%的患者有严重的合并伤。开放性骨折很常见，21例（62%）肢体发生开放性骨折。7例（21%）出现合并血管损伤。90%的骨折进行了手术固定。股骨和胫骨的平均愈合时间分别为39周和37.5周。膝关节平均屈曲度为96度（5-140度），5例（15%）膝关节出现屈曲挛缩。根据Karlström和Olerud制定的标准对结果进行分级。只有8例（24%）患者结果为良好或优秀。并发症很常见，11例（32%）肢体发生深部感染，3例（9%）患者因此行膝上截肢。这种浮动膝损伤亚组似乎与更高程度的全身创伤、更高比例的开放性损伤以及更严重的预后相关。
