Yadav Vishal, Suri Harpreet Singh, Vijayvargiya Mayank, Agashe Vikas, Shetty Vivek
Departmento de Ortopedia, P.D. Hinduja National Hospital, Mumbai, Maharashtra, India.
Rev Bras Ortop (Sao Paulo). 2019 Feb;54(1):53-59. doi: 10.1016/j.rboe.2017.09.007. Epub 2019 Mar 1.
Floating knee injuries are complex injuries and are usually caused by high-velocity trauma. These injuries are often associated with life treating injuries, which should take precedent over extremity injuries. The authors reviewed the outcomes of floating knee injuries managed in this institute from 2003 to 2015.
A retrospective study was conducted of all patients with floating knee injuries from2003 to 2015. Twelve patients were included in the study. Data related to fracture type, associated injuries, treatment modalities, and complications were noted. Functional assessment was performed using the modified Karlstrom and Olerud criteria after complete bony union.
The mechanism of injury was motor vehicle accident in all patients. The mean follow up was four years. The mean age of patients was 34.75 year. The mean union time was 6.5 months in femurs and 6.7 month in tibias. The complications were knee stiffness, delayed union, and infection. According to modified Karlstrom criteria, there were three - excellent, five - good, three - fair, and one poor result.
Floating knee injuries are severe injuries and are usually associated with multi-organ injuries. Early detection and appropriate management of associated injuries, early fixation of fractures, and postoperative rehabilitation are needed for good outcome. Complications are frequent, in the form of delayed union, knee stiffness, and infection.
浮动膝损伤是复杂损伤,通常由高速创伤所致。这些损伤常伴有危及生命的损伤,应优先处理危及生命的损伤,再处理肢体损伤。作者回顾了2003年至2015年在本机构治疗的浮动膝损伤的治疗结果。
对2003年至2015年所有浮动膝损伤患者进行回顾性研究。12例患者纳入研究。记录骨折类型、合并损伤、治疗方式及并发症等相关数据。在骨折完全愈合后,采用改良的卡尔斯特伦和奥勒鲁德标准进行功能评估。
所有患者的损伤机制均为机动车事故。平均随访时间为4年。患者平均年龄为34.75岁。股骨平均愈合时间为6.5个月,胫骨平均愈合时间为6.7个月。并发症包括膝关节僵硬、延迟愈合和感染。根据改良的卡尔斯特伦标准,结果为优3例、良5例、可3例、差1例。
浮动膝损伤是严重损伤,通常伴有多器官损伤。为获得良好的治疗效果,需要早期发现并妥善处理合并损伤,早期固定骨折,以及术后进行康复治疗。并发症常见,表现为延迟愈合、膝关节僵硬和感染。