European Journal of Molecular & Clinical Medicine

Abstract

Aim: To assess the outcome after internal fixation of floating knee.
Materials and Methods: Hospital based single center cross sectional descriptive type of
observational study among 80 patients in the department of Orthopedics in teaching hospitals
attached to S.M.S Medical College and hospital. After obtaining clearance and approval from
the institutional ethical committee and patients detailed history was obtained using the study
proforma with special attention to mechanism of injury. Examination of other associated
symptoms was based on history and clinical examination. Open reduction internal fixation of
floating knee under spinal anaesthesia under c-arm guidance. Routine antibiotics and
analgesic/anti-inflammatory drugs were administered. Post-operative evaluation was carried
out by clinical examination and X-ray. Functional assessment and final outcome were measured
according to the Karlstrom criteria.
Results: Male (85%) prominence was higher than females (15%). Mean age of male and female
was almost same. In the study, 17 (21.3%) patients did not have any associated injuries while
63 (78.1%) patients have any associated injuries among them, 52.5% patients have
Contralateral Limb Injury, 15% patients have head injury and 11.3% patients have pelvic
injury. In the study, 55% patients have grade I type, 20% patients have grade IIa type, 10%
patients have grade IIb type and 15% patients have grade IIc type. Right side (65%) most
common affected than left side (35%). RTA (80%) most common cause of trauma than FFH
(15%) and assault (5%). Close (60%) type of injury recorded higher than compound (40%).
Interlocking nail femur (70%) was most common treatment for fixation of femur fracture than
plating (20%) and external fixation (10%). Interlocking nail tibia (50%) was most common
treatment for fixation of tibia fracture than plating (30%) and external fixation (15%). Excellent
results was found in 40% patients, good results was found in 30% patients, fair results was
found in 20% patients and poor results was found in 10% patients.
Conclusion: The most important factors which determine the functional outcomes were the
type of fractures (open or closed), pattern of fracture, intraarticular involvement, and treatment
modality used. Fraser’s classification effectively classifies the injury and helps to determine
the eventual outcome of injury. Karlstrom criteria are an effective scoring system to grade the
functional outcome of floating knee injuries.