Authors
Abstract
Background: Ipsilateral fractures of tibia and femur or’ “floating knee”, commonly occur as a result of high energy trauma. It is, therefore, associated with high chance of knee injuries. This articles looks at the prevalence of intra-articular knee injury in “floating knee” when the fractures are extra-articular, both in tibia and femur.Methods: During a 3.5 year period of time (March 2002-Oct 2005), 61, out of total of 76 cases of “floating knees” that had extra-articular femur and tibia fractures, had no history of prior knee problems, and the fractures of both segments had been internally fixed were studied. Each knee was examined for any possible ligamentous injury, following rigid fixation of the fractures, under the same anesthesia. The findings were documented and the patients were later followed for any new findings or complaints up to nine months after the incident.Results: The mean age in these 61 cases (57 males, 4 females) was 29.3 (18-46). Lachman and Pivot tests were positive in 5 and Posterior Drawer test in 3 cases. Valgus instability in 9 and varus instability in 6 other cases were detected. After the 9-months follow-up, knee pain was the chief complaint in 19 patients, while the MRI study which was done in 16 cases was positive for meniscal damage in 13 patients.Conclusions: Concomitant knee insults are fairly common in “floating knee” injuries. A thorough knee examination, following fixation of "floating knee” fractures, while the patient is still under anesthesia is essential. Further evaluation during the course of fracture treatment for any knee complaint is also recommended.
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