Floating knee injuries: treatment with a single approach

Abstract

Introduction The ‘floating knee’, a term first used by Blake and McBride in 1974, describes concomitant fractures of the ipsilateral femur and tibia. ‘Floating knee’ injuries may include combinations of diaphyseal, metaphyseal and intra-articular fractures.Patients and methods We report a series of 21 patients who had Fraser type I floating knee injury treated with the retrograde femoral and antegrade tibial intramedullary nail using a single knee incision during a period between 2005 and 2009. The mean age of the patients at the time of injury was 30.6 years (range: 19–50 years); 17 of them were male and four were female. All patients had sustained their injuries in motor vehicle accidents.Results The average time for union of femoral shaft fractures was 15.8 (range: 8–56) weeks. The average time for union of tibial fractures was 22.9 (range: 18–30) weeks. There was no malunion exceeding 10° of angulation or rotation in either fracture. There was no patient leg length discrepancy. There was no deep infection. The final functional outcomes after bony union using the criteria of Karlström and Olerud were as follows: 11 excellent results (52.3%), six good (28.5%), three fair (14.3%) and one poor result (4.7%). The overall satisfactory outcome rate was 81% (17/21).

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