Rethnam Ulfin, Yesupalan Rajam S, Nair Rajagopalan
Department of Orthopaedics, Glan Clwyd Hospital, Bodelwyddan, UK.
J Trauma Manag Outcomes. 2007 Nov 26;1(1):2. doi: 10.1186/1752-2897-1-2.
Floating Knee injuries are complex injuries. The type of fractures, soft tissue and associated injuries make this a challenging problem to manage. We present the outcome of these injuries after surgical management.
29 patients with floating knee injuries were managed over a 3 year period. This was a prospective study were both fractures of the floating knee injury were surgically fixed using different modalities. The associated injuries were managed appropriately. Assessment of the end result was done by the Karlstrom criteria after bony union.
The mechanism of injury was road traffic accident in 27/29 patients. There were 38 associated injuries. 20/29 patients had intramedullary nailing for both fractures. The complications were knee stiffness, foot drop, delayed union of tibia and superficial infection. The bony union time ranged from 15 - 22.5 weeks for femur fractures and 17 - 28 weeks for the tibia. According to the Karlstrom criteria the end results were Excellent - 15, Good - 11, Acceptable - 1 and Poor - 3.
The associated injuries and the type of fracture (open, intra-articular, comminution) are prognostic indicators in the Floating knee. Appropriate management of the associated injuries, intramedullary nailing of both the fractures and post operative rehabilitation are necessary for good final outcome.
漂浮膝损伤是复杂的损伤。骨折类型、软组织及相关损伤使其成为一个具有挑战性的治疗难题。我们展示了手术治疗这些损伤后的结果。
在3年期间对29例漂浮膝损伤患者进行了治疗。这是一项前瞻性研究，漂浮膝损伤的两处骨折均采用不同方式进行手术固定。对相关损伤进行了适当处理。骨愈合后根据卡尔斯特伦标准对最终结果进行评估。
27/29例患者的损伤机制为道路交通事故。共有38处相关损伤。20/29例患者的两处骨折均采用髓内钉固定。并发症包括膝关节僵硬、足下垂、胫骨延迟愈合和浅表感染。股骨骨折的骨愈合时间为15 - 22.5周，胫骨骨折为17 - 28周。根据卡尔斯特伦标准，最终结果为优 - 15例，良 - 11例，可接受 - 1例，差 - 3例。
相关损伤及骨折类型（开放性、关节内、粉碎性）是漂浮膝损伤的预后指标。对相关损伤进行适当处理、对两处骨折进行髓内钉固定及术后康复对于获得良好的最终结果是必要的。
