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2018•MOJ Orthopedics & RheumatologyOpen access

Floating knee: epidemiological profile and management at the traumatology and orthopedics department (section A) of Hassan ii hospital, fez/Morocco

K. Lahrach, Boubacar Soumaré, Saeed Abdul Razak, Bah Thierno Souleymane, Diarra Abdoul Salam, Fawzi Boutayeb

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Abstract

Introduction: The floating knee is an association an ipsilateral in the lower limb first described by BLAKE and MCBRYDE in 1974. Diagnosis is based on clinical and radiological findings. Management must be prompt, multidisciplinary and optimal. The aim of this study is to analyze the epidemiological, diagnostic and therapeutic aspect of this pathology. Methods: we retrospectively reviewed the cases of 32 patients who were operated between January 2009 and November 2018. Only patients with a floating knee were included. Frazer’s classification was used for staging and indexing. Severity of associated injuries was assessed using the Injury Severity Score as well as Cauchoix-Duparc classification to evaluate open fractures preoperatively. Karlstrom and Olerud criteria were used to evaluate functional results. Results: Young active adults were the most affected with a mean age of 28years and a clear male predominance (90.62%). Road accidents were the main cause (93.75%). According to Fraser’s classification, 68.75% of cases were type I, type IIa (15.62 %), type IIb (9.37%) and type IIc (6.25%). Seventeen patients underwent IM nailing of both femur and tibia fractures. Four patients (12.5%) underwent ORIF with DCP femur plate; 3 patients (9.37%) underwent condylar plate bridging of the femur; whereas 2 patients (6.25%) underwent ORIF of tibia with DCP plate and 2 patients (6.25%) with T-buttress plate of the tibia plateau. Three patients benefitted from external fixation of tibia whereas, 1 patient underwent a femoral external fixation. The mean hospital -stay was 5days and 68.75% of the patients had favourable outcome with bone consolidation. Conclusion: The floating knee is an entity that is gradually becoming prevalent in our side of the globe usually involving young active adults. Diagnosis is radio-clinical most often. Management is operative and should be carried by an experienced multidisciplinary team

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Introduction: The floating knee is an association an ipsilateral in the lower limb first described by BLAKE and MCBRYDE in 1974. Diagnosis is based on clinical and radiological findings. Management must be prompt, multidisciplinary and optimal. The aim of this study is to analyze the epidemiological, diagnostic and therapeutic aspect of this pathology. Methods: we retrospectively reviewed the cases of 32 patients who were operated between January 2009 and November 2018. Only patients with a floating knee were included. Frazer’s classification was used for staging and indexing. Severity of associated injuries was assessed using the Injury Severity Score as well as Cauchoix-Duparc classification to evaluate open fractures preoperatively. Karlstrom and Olerud criteria were used to evaluate functional results. Results: Young active adults were the most affected with a mean age of 28years and a clear male predominance (90.62%). Road accidents were the main cause (93.75%). According to Fraser’s classification, 68.75% of cases were type I, type IIa (15.62 %), type IIb (9.37%) and type IIc (6.25%). Seventeen patients underwent IM nailing of both femur and tibia fractures. Four patients (12.5%) underwent ORIF with DCP femur plate; 3 patients (9.37%) underwent condylar plate bridging of the femur; whereas 2 patients (6.25%) underwent ORIF of tibia with DCP plate and 2 patients (6.25%) with T-buttress plate of the tibia plateau. Three patients benefitted from external fixation of tibia whereas, 1 patient underwent a femoral external fixation. The mean hospital -stay was 5days and 68.75% of the patients had favourable outcome with bone consolidation. Conclusion: The floating knee is an entity that is gradually becoming prevalent in our side of the globe usually involving young active adults. Diagnosis is radio-clinical most often. Management is operative and should be carried by an experienced multidisciplinary team

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Available abstract

Introduction: The floating knee is an association an ipsilateral in the lower limb first described by BLAKE and MCBRYDE in 1974. Diagnosis is based on clinical and radiological findings. Management must be prompt, multidisciplinary and optimal. The aim of this study is to analyze the epidemiological, diagnostic and therapeutic aspect of this pathology. Methods: we retrospectively reviewed the cases of 32 patients who were operated between January 2009 and November 2018. Only patients with a floating knee were included. Frazer’s classification was used for staging and indexing. Severity of associated injuries was assessed using the Injury Severity Score as well as Cauchoix-Duparc classification to evaluate open fractures preoperatively. Karlstrom and Olerud criteria were used to evaluate functional results. Results: Young active adults were the most affected with a mean age of 28years and a clear male predominance (90.62%). Road accidents were the main cause (93.75%). According to Fraser’s classification, 68.75% of cases were type I, type IIa (15.62 %), type IIb (9.37%) and type IIc (6.25%). Seventeen patients underwent IM nailing of both femur and tibia fractures. Four patients (12.5%) underwent ORIF with DCP femur plate; 3 patients (9.37%) underwent condylar plate bridging of the femur; whereas 2 patients (6.25%) underwent ORIF of tibia with DCP plate and 2 patients (6.25%) with T-buttress plate of the tibia plateau. Three patients benefitted from external fixation of tibia whereas, 1 patient underwent a femoral external fixation. The mean hospital -stay was 5days and 68.75% of the patients had favourable outcome with bone consolidation. Conclusion: The floating knee is an entity that is gradually becoming prevalent in our side of the globe usually involving young active adults. Diagnosis is radio-clinical most often. Management is operative and should be carried by an experienced multidisciplinary team

Key concepts: Traumatology, Orthopedic surgery, Medicine, Orthopedic trauma, Carpal tunnel release, Chondroplasty, Epidemiology, Foot and ankle surgery

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