The double floating extremity phenomenon: case studies and evidence-based perspectives.

Area of Science:

• Orthopaedic trauma
• Surgical management
• Functional recovery outcomes

Background:

• Double floating extremity is a rare condition involving simultaneous ipsilateral hip and knee injuries.
• High-velocity trauma is the common cause, often associated with severe systemic injuries.
• Lack of standardized treatment protocols presents management challenges.

Purpose of the Study:

• To review clinical outcomes and management strategies for double floating extremity injuries.
• To analyze functional recovery using validated scoring systems.
• To identify optimal treatment approaches for this rare condition.

Main Methods:

• Retrospective review of thirteen cases of double floating extremities.
• Assessment of functional outcomes using Knee Function Score (KFS), Knee Society Score (KSS), Majeed score, Merle d'Aubigné score, and Lower Extremity Function Score (LEFS).
• Follow-up assessments at 3, 6, and ≥12 months post-injury.

Main Results:

• Eleven of thirteen patients achieved good-to-excellent long-term functional outcomes (mean Merle d'Aubigné score 15.36, mean LEFS 65.27).
• Mean Injury Severity Score (ISS) was 22.5, indicating significant trauma.
• Early femur/tibia fixation followed by delayed pelvic fixation was a successful strategy; two patients died from systemic complications.

Conclusions:

• Double floating extremity injuries necessitate a systematic, phased approach with staged fixation and multidisciplinary care.
• Injury Severity Score (ISS) aids in quantifying systemic injury burden.
• Staged fixation strategies, tailored to patient condition, can enhance functional outcomes, but standardized protocols are needed.