International Journal of Orthopaedics Sciences

Functional outcome of the knee after surgical management of floating knee injuries by internal fixation only: A prospective study

2019, Volume 5 Issue 3

Functional outcome of the knee after surgical management of floating knee injuries by internal fixation only: A prospective study

Author(s): Dr. Syed Shahebaz Hussain Kazmi and Dr. Ramalingaiah A
Abstract: 
Background: Ipsilateral femoral and tibial fractures are referred to as floating knee injuries. But recent literature has however expanded this term to include most ipsilateral fractures of the femur and tibia i,e both diaphyseal, metaphyseal and intra articular fractures.
These are always associated with high morbidity. These are extremely heterogeneous groups of injuries. These combined injury patterns are typically due to high-energy mechanisms. Most of these injuries result in some permanent disability. The implant choice needs to be determined depending on nature of fracture and soft tissue injuries. A specific pattern of management can often not be determined. In view of the high complications rate and the unavailabiltity of a specific treatment guideline, there is a need for undertaking such a study.
Materials and Methods: This study is prospective study done during the period of 2016 to 2018 and is about the Functional Outcome of Surgical Managements of Floating Knee by internal fixation only. For this study 30 patients with ipsilateral femur and tibia fractures who presented to Hospitals attached to BMCRI i,e Victoria and Bowring hospitals’ casualty from October 2016- October 2017, were included according to inclusion criteria. Detailed history was obtained using Performa with special attention to mechanism of injury. Evaluations of other associated symptoms was done based on history and physical examination. The plan of management for the given patient was made depending on the nature of fracture, location of fracture, associated soft tissue injuries. Follow up study was done at 4 weeks,8 weeks, 12 weeks, 6 months and 1 year. Serial x-rays and functional assessment were carried out at each visit in outpatient clinic itself using the Karlstorm and Oleruds criteria.
Results: As per Karlstrom and Olerud’s criteria 43.3% had excellent outcome, 43.3% had good outcome, 10.0% had accep outcome and 3.3% had poor outcome.
Conclusion: Patients who undergo primary nailing will have Excellent or Good results. The most important factors which determine the functional outcomes were the type of fractures (open or closed), location of fracture, presence of comminution, intraarticular extensions, timing of fixations and post-operative infections, and associated co-morbid complications.
Pages: 220-231  |  928 Views  88 Downloads
How to cite this article:
Dr. Syed Shahebaz Hussain Kazmi, Dr. Ramalingaiah A. Functional outcome of the knee after surgical management of floating knee injuries by internal fixation only: A prospective study. Int J Orthop Sci 2019;5(3):220-231. DOI: 10.22271/ortho.2019.v5.i3d.1535
 
International Journal of Orthopaedics Sciences
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