“Floating knee”, ipsilateral fractures of femur and tibia
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 2
Abstract
Ipsilateral fractures of femur and tibia become more frequent and difficult clinical problem. It is a result of civilization progress and as an access to faster motor vehicles. They include combinations of shaft, diaphyseal, metaphyseal, and intra-articular fractures of tibia and femur. These combinations of fractures are called “floating knee”, but exclude combination of proximal femur fracture with distal tibia fracture, as it is connected with different prognosis and therapeutic approach. Floating knee is a result of high-energy trauma, have many comorbidities and is associated with polytrauma. Many of these fractures are open, with associated vascular or nerve injuries. Patient should be treated in level I trauma centers as they require precise diagnostic tools and cooperation of different specialties (medical, surgical, critical care and physical therapy). Surgical stabilization of fractures and early mobilization of the patient produce the best clinical outcomes. Additionally, considering severity of the injury, treatment planning for each fracture in the extremity should be considered individually to achieve the optimal result. In our article we describe ways of fixing ipsilateral fractures of femur and tibia. Proposed methods, in our opinion give the chance for preserving the function of limb. We also discuss severity of comorbid traumas. Complications such as compartment syndrome, loss of knee motion are not infrequent and may lead to arthrodesis or amputation. Better results and fewer complications are observed when both fractures are diaphyseal or within shaft of the bone.
Authors and Affiliations
Bogumił Leszczyński, Waldemar Rylski, Stanisław Pomianowski, Jan Orłowski
Keywords
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