Outcomes and prognostic factors of surgical management of floating knee injuries

Abstract

Background Floating knee injuries are complex injuries that are generally caused by a high-energy trauma such as a motorcycle or a car accident. Local trauma to the musculoskeletal and the soft tissues is often extensive and life-threatening; associated injuries may also be present, producing a challenging problem to manage. In this study, the authors presented the outcome of these injuries after surgical management. Patients and methods In this prospective study, 32 patients with 34 floating knee injuries were managed over a 3-year period; both fractures of the floating knee injury were fixed surgically by different modalities. The associated injuries were managed appropriately. Fractures were classified according to Fraser classification, and the outcome was evaluated by the Karlstrom criteria. Results The main mode of injury was motorcycle accident (62.2%). Twenty-nine (90.3%) patients had associated visceral or skeletal injuries. The complications presented in 17 (50%) patients. According to the Karlstrom criteria, the end results were as follows: excellent − 15 (44%), good − seven (20.6%), acceptable − eight (23.6%), and poor − four (11.8%). Conclusion The optimal final outcome of floating knee injuries was achieved with appropriate management of the associated injuries, intramedullary nailing of both the fractures and early aggressive postoperative rehabilitation. The associated injuries and the type of fracture (open, intra-articular, comminution, knee ligament injuries) are the prognostic indicators in the floating knee.