Mahmood Karimi Mobarakeh, MD; Mohammad Hasan Fadaee, MD; Massoud Mehdinejad Yazdi, MD
Abstract
Background: Ipsilateral fractures of femur and tibia, the so called “floating knee” are usually the result of high-energy trauma. They are associated with increased risk of local soft tissue injuries around the knee including ligamentous injuries, delayed :::union:::, and more importantly, vascular ...
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Background: Ipsilateral fractures of femur and tibia, the so called “floating knee” are usually the result of high-energy trauma. They are associated with increased risk of local soft tissue injuries around the knee including ligamentous injuries, delayed :::union:::, and more importantly, vascular injuries.Methods: In a cross sectional study of “floating knee” injuries treated in a training hospital of Kerman-Iran over a 1 year period (2003 to 2004) was performed. Seventy eight patients (69 males, 9 females), with a maximum follow-up of 2 weeks entered the study and are reported here. The injury type and, in particular, the vascular status of the limb in terms of prevalence and the fate of limb in first two weeks were the points of concern. Seventy eight “floating knee” patients comprised the study group that was divided into six groups in accordance with the limb vascular status. Each “floating knee” case was further classified according to the level and type of each bone fracture.Results: Out of 78 cases 18 has no pulse and did not regain any hemodynamic stabilization, and 13 had angiography and 5 went directly for arterial exploration. In general 15 cases (19.2%) of “floating knees” had vascular compromise, 8 of whom ended up with amputation. The vascular damage had no direct correlation with age, or anatomic location of fractures.Conclusions: Simultaneous ipsilateral fractures of femur and tibia are associated with around 20 percent chance of vascular injury. Careful and immediate assessment of limb circulation is mandatory for any “floating knee” injuries.
