Minimally invasive plate osteosynthesis for complex comminuted bone fractures in the Fraser's type II floating knee:...

Floating knee type IIC, according to Fraser's classification, is an uncommon severe injury that typically occurs in polytrauma. In such cases, intra-articular fracture and the high degree of comminution and deformity of the mid-distal femur make fixation challenging. The purpose of this study was to demonstrate that minimally invasive plate osteosynthesis (MIPO) technology can simplify these complex problems and improve patient prognosis.

A 38-year-old man injured his left leg in a car accident, causing pain, swelling, deformity, and limited mobility on his left knee and thigh, and two small open wounds were noted mainly of the anterior aspect of the mid-distal thigh. Physical examination and computed tomography angiography of the lower limb confirmed that there was no damage to the neurovascular system. The clinical diagnosis was closed intra-articular fracture of the proximal tibia, open intra-articular fracture of the distal femur with extension to the diaphysis, and a patellar fracture on the ipsilateral knee. The treatment strategy involved a locking plate system applying MIPO technology. Postoperative evaluation of the patient was satisfactory, with immediate functional exercise, full weight-bearing after three months, and return to daily activity without pain. Final follow-up taken 3 years after surgery showed good lower limb alignment and complete plasticity of the bone structure, by which time the patient showed good limb function.

Minimally invasive techniques can provide a simple and effective treatment for some complex fractures.