TO EVALUATE THE FUNCTIONAL OUTCOME IN PATIENTS WITH FLOATING KNEE WHO UNDERWENT MAGNETIC RESONANCE IMAGING

SAUMYA AGARWAL; HARPREET SINGH; ANAMENDRA SHARMA; KALIKA GUPTA

doi:10.22159/ajpcr.2024v17i8.51502

Authors

SAUMYA AGARWAL Department of Orthopaedics, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India https://orcid.org/0000-0002-5429-8717
HARPREET SINGH Department of Orthopaedics, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
ANAMENDRA SHARMA Department of Orthopaedics, RNT Medical College, Udaipur, Rajasthan, India.
KALIKA GUPTA Department of Community Medicine, Ananta Institute of Medical Sciences, Rajsamand, Rajasthan, India.

DOI:

https://doi.org/10.22159/ajpcr.2024v17i8.51502

Keywords:

Floating knee, Ipsilateral femur and tibia, Ligament injury, Magnetic resonance imaging, Soft tissue injury

Abstract

Objective: The incidence of floating knee injuries has traditionally been underestimated. However, with the increased use of magnetic resonance imaging (MRI) and arthroscopy, their frequency has risen. There is a crucial need to classify this complex injury pattern by also considering associated soft-tissue injuries. Soft-tissue injuries might be missed during clinical examination due to tenderness and swelling but can be detected through immediate MRI scans. This study aimed to evaluate the functional outcomes of patients with floating knee injuries who underwent MRI for soft tissue injuries.

Methods: This study was conducted at a tertiary care center from February 2021 to January 2024. The study involved 100 patients with floating knee injuries who underwent MRI assessments for soft-tissue injuries. Follow-ups were scheduled at 1 month, 3 months, 6 months, and 1 year, with a maximum follow-up duration of 2½ years. The outcomes of floating knee injuries were assessed using the Karlstrom Olerud criteria.

Results: Among 100 patients with floating knee injuries who underwent MRI, 72 had meniscus or ligament injuries, and nine had patellar fractures with extensor mechanism rupture. According to the Karlstrom Olerud criteria, seven patients had excellent outcomes, 46 had good outcomes, 33 had fair outcomes, and six had poor outcomes. Eight patients were lost to follow-up.

Conclusion: Our aim is to ensure timely and accurate treatment by thoroughly addressing all associated injuries, including often-overlooked ligament damage around the knee. To improve clinical outcomes, we recommend a multidisciplinary approach involving various specialists in the care of these patients.

Downloads

Download data is not yet available.

References

Hayes JT. Multiple fractures in the same limb: Some problems in their management. Surg Clin North Am. 1961;41(5):1379-88. doi: 10.1016/ S0039-6109(16)36499-4

McBryde A Jr., Blake R. The floating knee: Ipsilateral fractures of femur and tibia. J Bone J Soint Surg. 1974 Sep;56(A):1309.

Agarwal S, Singh H, Sharma A, Gupta K. To develop a classification system for prognosis of cases of floating knee. Int J Pharm Clin Res. 2024;16(1):1630-3.

Karlstrom G, Olerud S. Ipsilateral fracture of the femur and tibia. J Bone Joint Surg. 1977;59(A):240-3.

Fraser RD, Hunter G. A Ipsilateral fractures of the femur and tibia. J Bone Joint Surg. 1978;142(B):115-22.

Paul GR, Sawka MW, Whitelaw GP. Fractures of the ipsilateral femur and tibia: Emphasis on intra-articular and soft tissue injury. J Orthop Trauma. 1990;4(3):309-14. doi: 10.1097/00005131-199004030-00013, PMID 2231130

Doyle P, Oliver CW. Complex floating knee; Trifocal tibial and ipsilateral femoral fracture. Injury. 1998;29(7):553-5. doi: 10.1016/ s0020-1383(98)00111-9, PMID 10193502

Liu Y, Zhang J, Zhang S, Li R, Yue X. Concomitant ligamentous and meniscal injuries in floating knee. Int J Clin Exp Med. 2015 Jan 15;8(1):1168-72. PMID 25785109

Szalay MJ, Hosking Szalay MJ, Annear P. Injury of knee ligament associated with ipsilateral femoral shaft fractures and with ipsilateral femoral and tibial shaft fractures. Injury. 1990;21(6):398-400.

Karslı B, Tekin SB. The floating knee injuries: Does it need a new

classification system? Indian J Orthop. 2020 Nov 3;55(2):499-505. doi: 10.1007/s43465-020-00298-x, PMID 33927831

Rollo G, Falzarano G, Ronga M, Bisaccia M, Grubor P, Erasmo R, et al. Challenges in the management of floating knee injuries: Results of treatment and outcomes of 224 consecutive cases in 10 years. Injury. 2019 Aug;50(Suppl 4):S30-8. doi: 10.1016/j.injury.2019.03.016, PMID 30910244

Chavda AG, Lil NA, Patel PR. An approach to floating knee injury in Indian population: An analysis of 52 patients. Indian J Orthop. 2018 Nov- Dec;52(6):631-7. doi: 10.4103/ortho.IJOrtho_31_17, PMID 30532304

Feron JM, Bonnevialle P, Pietu G, Jacquot F. Traumatic floating knee: A review of a multi-centric series of 172 cases in adult. Open Orthop J. 2015 Jul 31;Suppl 1 M11:356-60.

Ran T, Hua X, Zhenyu Z, Yue L, Youhua W, Yi C, et al. Floating knee: A modified Fraser’s classification and the results of a series of 28 cases. Injury. 2013;44(8):1033-42. doi: 10.1016/j.injury.2012.12.012, PMID 23312566

Rethnam U, Yesupalan RS, Nair R. The floating knee: Epidemiology, prognostic indicators and outcome following surgical management. J Trauma Manag Outcomes. 2007;1(1):2.