Long-term study of functional outcomes of floating knee injuries

Abstract

Background: Floating knee injuries are commonly occurring fractures in the high-velocity trauma. The mode of injury is usually due to road traffic accidents. Over the years, there have been many studies which have shown results of various conservative, external fixation, and finally, internal fixation treatment all over the world. However, still, there is very less work on long-term outcome-based analysis of functional outcomes of floating knee injuries. The aim of the study was to assess the long-term functional outcome of operated patients of floating knee injuries. Materials and Methods: A total of 30 patients with floating knee injuries who were undergone surgical fixation by any means were included in ths study. The study was done at a tertiary teaching institute and hospital from April 2013 to May 2019. The patients were followed up at 6 weeks, 6 months, 1 year, and 5 years (final) after the surgery. The assessment of pain, functional activity, walking ability, and range of motion was assessed by Karlstrom and Olerud criteria at 6 months, 1 year, and 5 years. Results: We included 30 patients diagnosed with floating knee injuries in our study with a mean age of 40.83 years (18–75 years range) and a female-to-male ratio of 5:1 with 25 males (83.3%) and 5 females (16.7%). All the patients underwent fixation under spinal/epidural anesthesia/general anesthesia. Fifteen patients were Fraser type 1, 4 patients were Fraser type 2A, 5 patients were Fraser type 2B, and 6 patients were Fraser type 2C. Average operating time was 120 ± 55 min. Right-sided involvement was more common (17 patients) than the left side (13 patients). The good/excellent outcome was found in 63.4% of the cases. Patients with age 40 years of age (df = 12, P = 0.014). Final outcomes had no difference in males as compared to females at 5 years postoperatively (df = 4, P = 0.265). Complications such as knee stiffness, infection, malunion, delayed union, and nonunion were also encountered. Conclusion: Surgical fixation is an effective treatment for floating knee injuries worldwide. On long-term follow-up of patients treated surgically, the functional and radiological outcomes were good with few complications rates.