Neglected infected floating knee injury: evaluation of closed reduction techniques

Area of Science:

• Orthopedic surgery
• Traumatology

Background:

• Floating knee injuries are complex, especially when infected, open, comminuted, or presenting late.
• Management of such cases presents significant challenges in achieving union and functional recovery.

Purpose of the Study:

• To assess the efficacy of closed reduction using circular external fixation in a single stage for treating infected neglected floating knee injuries.
• To evaluate outcomes including union, infection control, and functional results.

Main Methods:

• Retrospective analysis of 19 patients with infected neglected floating knee injuries.
• Treatment involved closed reduction with Ilizarov principles and circular external fixation.
• Orthoplastic procedures were performed in four cases during the same surgical setting.

Main Results:

• Successful closed reduction and union achieved in all 19 patients.
• Infection controlled in 17 cases; mean knee flexion was 97.4° after a 41-month follow-up.
• Complications included extension lag, malunion, refracture, and deep vein thrombosis (DVT); bone and functional results varied.

Conclusions:

• Circular external fixation offers a viable single-stage treatment for infected neglected floating knee injuries without bone grafting.
• High complication rates and potential for decreased knee range of motion necessitate careful consideration.