Kurkowski Sarah, Catlett Sean, Gerak Samuel, Mor Huertas Andres, Beltran Michael
Department of Orthopaedic Surgery, University of Cincinnati - 231 Albert Sabin Way, Cincinnati, Ohio, 45267, United States.
College of Medicine, University of Cincinnati - 231 Albert Sabin Way, Cincinnati, Ohio, 45267, United States.
Injury. 2025 Oct;56(10):112679. doi: 10.1016/j.injury.2025.112679. Epub 2025 Aug 10.
To compare the rate of unplanned reoperation to address fracture-related complications between extraarticular floating knee fracture patterns and those involving the articular surface of the knee, and to assess the impact of concomitant patella fracture on outcomes.
Design: Retrospective study of patients with a floating knee injury treated at a single level 1 trauma center from 2012-2022.
Single, urban, level 1 trauma center. Patient selection criteria: Patients ≥18 years old with a floating knee injury treated at a single urban level 1 trauma center from 2012-2022, with at least 3 months of followup. Outcome measures and comparisons: The primary outcome measure was the rate of unplanned reoperation to treat infection, obtain union, or surgically address knee stiffness.
Reoperation to address fracture-related complications was high in both extra and intraarticular floating knee patterns, with a trend toward more surgery to address knee stiffness in those with articular involvement (p = 0.078). Concomitant patella fracture and open fracture were present in 12 and 46 of the 64 patients, respectively; the presence of open fracture was significantly associated with reoperation to address either nonunion or infection (p < 0.001). An associated patella fracture was significantly associated with requiring surgery to address knee stiffness (p = 0.009).
Floating knee injuries with at least one articular fracture, especially when the patella is involved, had higher rates of surgery for knee stiffness. Intraarticular floating knee injuries are challenging, often requiring reoperation for infection, nonunion, or stiffness. Surgeons should be proactive with early motion protocols, supervised therapy, and tools like continuous passive motion to reduce knee stiffness risk.
III.
比较关节外浮膝骨折类型与涉及膝关节面的骨折类型之间，为处理骨折相关并发症而进行的非计划再次手术的发生率，并评估髌骨骨折伴发情况对治疗结果的影响。
设计：对2012年至2022年在一家一级创伤中心接受治疗的浮膝损伤患者进行回顾性研究。
单一的城市一级创伤中心。患者选择标准：2012年至2022年在一家城市一级创伤中心接受治疗的年龄≥18岁的浮膝损伤患者，且随访至少3个月。结果测量与比较：主要结果测量指标是为治疗感染、实现骨愈合或通过手术处理膝关节僵硬而进行的非计划再次手术的发生率。
关节外和关节内浮膝骨折类型中，为处理骨折相关并发症而进行的再次手术发生率都很高，关节受累患者中为处理膝关节僵硬而进行更多手术的趋势（p = 0.078）。64例患者中，分别有12例和46例存在髌骨骨折伴发和开放性骨折；开放性骨折的存在与为处理骨不连或感染而进行的再次手术显著相关（p < 0.001）。相关的髌骨骨折与需要通过手术处理膝关节僵硬显著相关（p = 0.009）。
至少有一处关节骨折的浮膝损伤，尤其是涉及髌骨时，因膝关节僵硬而进行手术的发生率更高。关节内浮膝损伤具有挑战性，常常需要因感染、骨不连或僵硬而进行再次手术。外科医生应积极采用早期活动方案、监督治疗以及持续被动活动等工具，以降低膝关节僵硬的风险。
三级。
