Floating knee injuries: postoperative complications and outcome.

OBJECTIVE

To evaluatepost-operative complications and functional outcome of floating knee injuries using Karlstrom's criteria.

METHODS

The prospective randomised study was conducted at Allied Hospital, Faisalabad, Pakistan, from November 2013 to October2014, and comprised patients of either gender. The injuries were classified using Fraser classification. Femur fractures were treated with intramedullary nails, dynamic hip screws, dynamic condylar screws, dynamic compression plates, buttress plates or external fixators. Tibia fractures were treated with buttress plates, dynamic compression plates, intramedullary nails, inter-fragmentary screws or external fixators.Patients were monitored at 1, 2, 3 and 6 months postoperatively. Final outcome was measured by Karlstrom's criteria.

RESULTS

Of the 65 patients, 50(77%) were males and 15(23%) were females. According to Fraser classification, there were 46(70.8%)type I, 3(4.6%) type IIa, 7(10.8%) type IIb, and 9(13.8%) type IIc injuries. Most injuries were sustained during motor bike accidents 59(90.8%) involving right limb 38(58.5%) more than the left 27(41.5%), and 22(33.8%) had associated bony injuries and 4(6.2%) had visceral injuries. Non-union occurred in 16(12.3%) fractures, amputation in 5(7.7%), stiffness in 21(32.3%), soft tissue complications requiring reconstruction in 5(7.7%), infection in femur 11(16.9%), and infection in tibia 13(20%). Outcome was Excellent in 16(24.6%), Good 26(40%), Satisfactory 16(24.6%) and Poor 7(10.8%).

CONCLUSIONS

A better functional outcome without sequelae/complications depends on the choice of implants according to Fraser classification, comminution at fracture site, intra- or extra-articular nature and whether the fracture is open or closed.