Online ISSN: 2515-8260

Keywords : Floating knee

Floating knee injuries: Associated injuries and clinical outcome

Dr. Himanshu Agrahari, Dr. Chethan MH, Dr. Siddharth Dubey, Dr. Bhaskar Sarkar, MD Quamar Azama

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 258-266

Background: Floating knee injuries are frequently part of polytrauma. The outcome of this injury
pattern when compared to only femur or tibia fracture is less satisfactory. The outcome is even worse
when there is presence of other associated injuries. We hypothesized that not all associated injuries
have similar bearing on the outcome thus tried to find out the impact of commonly associated injuries
on the final outcome of these complex fractures.
Methods: Study was conducted including the patients of floating knee injury operated between
September 2016 and January 2019. Total of 42 eligible patients were operated, 4 patients were
excluded to due to lack of adequate follow-up. Data relating to demography, Fraser subtype,
compounding, associated injuries and clinical outcome were collected. Statistical analysis was
performed to see the association of associated injury, Fraser subtype and presence of compounding
with clinical outcome.
Results: Mean age was 33.5 years (17-63 years) with a male preponderance. Mean follow up was 1.6
years. Twenty-seven patients (71.1%) had excellent/good outcome while outcome of 11 patients
(28.9%) was acceptable/poor. Seventeen patients (44.7%) had compound fractures. Injuries which were
significantly associated with Acceptable/Poor outcome were ligament injuries, popliteal artery injury,
abdominal injury and patella fracture. Chest injury with a p value of 0.05 was also very close to being
statistically significant.
Conclusion: The clinical outcome of these patients not only depend on proactive and optimum
management of tibial and femoral fractures but also on the management of associated injuries.


Dr Sreekanth Kashayi-Chowdojirao, Dr Raja Ramesh Badavath, Dr Kethan Kumar Tekuri, Dr K J Suvarna Rekha, Dr Raju Iyengar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11827-11842

Background: As a result of high-speed traffic accidents, the frequency of ipsilateral femur and tibia fractures has risen. Because of the complicated fracture pattern and concomitant soft tissue damage, predicting the surgical prognosis of floating knee injuries is challenging. The goal of this research is to examine the functional outcome of a Frasers type II floating knee injury following surgery.
Methods: This is a prospective study done at NIMS, Hyderabad between  Nov 2019 and May 2020. The sample size is 20 patients between the age group 20-60 years. The clinical, radiological and functional outcome of these injuries were evaluated using Karlstrom and Olerud criteria.
Results: With a mean age of 35.5 years, there were 18 (90%) males and 2 (10%) females. In our study, 50% of the injuries were type IIC (both were intra-articular), 25% were type IIA, and 25% were type IIB. According to the Karlstrom and Olerud criteria, there were 2 (10%) outstanding, 7 (35%), good, 6 (30%) fair, and 5 (25%), bad outcomes after an average of 12.7 months (range 8 to 18 months) of follow up.
According to Chi square analysis, there is no significant relationship between the factors utilised and functional result, and the strength of the relationship is weak.
Conclusion: Ipsilateral femur and tibia fractures are a more difficult injury that has a higher risk of sequelae.Prognostic indications include concomitant injuries, fracture type (open, intra-articular, comminution), and accompanying patellar fractures. For a satisfactory functional result, early stabilisation and intensive rehabilitation are essential.