Orthopaedic Surgery Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Vall D'Hebron Institut de Recerca, Barcelona, Spain.
Eur J Orthop Surg Traumatol. 2022 Feb;32(2):325-331. doi: 10.1007/s00590-021-02981-7. Epub 2021 Apr 21.
Ipsilateral femur and tibia fractures around the knee (floating knee) are rare injuries that threaten both limb viability and patient life. A correct surgical strategy is essential to reduce complications and sequelae. The aim of this study was to evaluate characteristics and results of treatment in patients with a floating knee treated at a single trauma center.
This is a retrospective and non-consecutive case series of 18 floating knees occurred in 17 patients. All patients were operated in a single third-level public and university hospital from December 2010 to December 2018. Data on demographics, injuries, treatment and follow-up were collected. A general health questionnaire (SF-12) and a knee functional questionnaire (KOOS-PS) were used to display results.
We identified 13 men and 4 women, aged between 16 and 52. Mean follow-up period was 16.49 months. High-energy trauma following a traffic collision was the most frequent mechanism. Mean Injury Severity Score (ISS) was 39.05, and a damage control strategy was used in 15 (83.33%) injuries. Extra-articular fractures (Fraser I) largely predominated, resulting in double intramedullary nailing in 72.22% of cases. Eleven injuries (61.11%) presented with an open fracture. Complications appeared in 6 (33.33%) injuries, being 3 infections. Mean score for the SF-12 was 35.59 for the physical dimension and 50.44 for mental dimension. Mean score for the KOOS-PS was 43.64.
Floating knee injuries usually occur in polytrauma contexts. Visceral involvement and exposed fractures are common, so the most appropriate strategy is usually a staged treatment. Complications and sequelae are frequent.
膝关节周围同侧股骨和胫骨骨折（浮动膝）较为罕见，既威胁肢体存活，又危及患者生命。正确的手术策略对于减少并发症和后遗症至关重要。本研究旨在评估在一家创伤中心治疗的浮动膝患者的特点和治疗结果。
这是一项回顾性的、非连续的病例系列研究，纳入了 17 例患者的 18 例浮动膝。所有患者均于 2010 年 12 月至 2018 年 12 月在一家三级公立大学医院接受手术治疗。收集了患者的人口统计学、损伤、治疗和随访数据。使用一般健康问卷（SF-12）和膝关节功能问卷（KOOS-PS）来展示结果。
我们纳入了 13 名男性和 4 名女性，年龄 16 至 52 岁。平均随访时间为 16.49 个月。最常见的损伤机制是交通伤导致的高能量创伤。平均损伤严重度评分（ISS）为 39.05，15 例（83.33%）患者采用损伤控制性策略。关节外骨折（Fraser I 型）占绝大多数，72.22%的病例采用双髓内钉固定。11 例（61.11%）开放性骨折。6 例（33.33%）出现并发症，其中 3 例为感染。SF-12 的生理维度平均评分为 35.59，心理维度平均评分为 50.44。KOOS-PS 的平均评分为 43.64。
浮动膝损伤通常发生在多发伤背景下。常伴有内脏损伤和开放性骨折，因此最合适的策略通常是分期治疗。并发症和后遗症较为常见。
