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Variables affecting functional outcome in floating knee injuries.

Mahesh Suresh Kulkarni1, Monappa Naik Aroor1, Sandeep Vijayan1

  • 1Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Udupi, Karnataka, 576104, India.

Injury
|June 11, 2018
PubMed
Summary
This summary is machine-generated.

Predicting surgical outcomes for floating knee injuries is challenging. Open tibial fractures, segmental fractures, and intra-articular involvement are poor prognostic indicators for functional recovery.

Keywords:
Damage control orthopedicsFloating kneeIpsilateral femur and tibia fracturesKarlstrom criteriaKnee injuriesMultiple fracturesPoly trauma

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Biomechanics

Background:

  • Floating knee injuries present complex challenges in predicting surgical outcomes.
  • High-velocity trauma, intricate fracture patterns, and associated soft tissue or visceral injuries complicate functional recovery.
  • This study investigates factors influencing clinical and radiological results in floating knee injuries.

Purpose of the Study:

  • To identify variables that significantly impact the clinical and radiological outcomes of floating knee injuries.
  • To establish prognostic indicators for functional recovery following these severe knee traumas.

Main Methods:

  • A retrospective analysis of 90 floating knee injuries in 89 patients managed at a level 1 trauma center from 2013 to 2016.
  • Clinical, radiological, and functional outcomes (using Karlstrom and Olegrud criteria) were assessed at one-year follow-up.
  • Injury details, fracture patterns, management strategies, and complications were meticulously recorded.

Main Results:

  • Open tibial fractures, segmental fractures, intra-articular involvement, and the need for additional surgical procedures were significantly associated with poor outcomes.
  • Factors like knee stiffness, limb length discrepancy, and malunion were common complications.
  • Initial external fixator application also correlated with unsatisfactory functional results.

Conclusions:

  • Open tibial fractures, segmental fractures, intra-articular involvement, additional surgical procedures, and initial external fixator application are identified as poor prognostic indicators for floating knee injuries.
  • These findings aid in risk stratification and management planning for patients with floating knee injuries.