[The floating knee in adults: twenty-four cases of ipsilateral fractures of the femur and the tibia].
OBJECTIVE
We evaluated the presenting features of ipsilateral femoral and tibial fractures in adults, and the effects of both fracture type and severity of skeletal injury on the results.


METHODS
The study included 24 patients (22 men, 2 women; mean age 38 years; range 17 to 75 years). According to the classification by Letts et al., the types of the fractures were as follows: type A (7), type B (2), type C (5), type D (7), and type E (3). Femur fractures were treated by locked intramedullary nails, AO plates, plate-screws, unilateral external fixator, or dynamic condylar screws, and tibia fractures by external fixator, plate-screws, locked intramedullary nailing, or with conservative methods. Amputation at the fracture level was required in a patient with type 3C open tibia fracture. The mean follow-up was 3.2 years (range 1.3 to 7 years).


RESULTS
According to the criteria by Kalström and Olerud, the results were excellent in three patients, good in nine patients, fair in five patients, and poor in six patients. The mean skeletal injury scores were 4.4 and 3 in patients having fair and poor results and in those with good and excellent results, respectively. Fair and poor results corresponded to type A (1 patient), type C, type D, or type E fractures. Five patients with type 3 open fractures had fair or poor results. Thirteen patients (54%) had at least one complication.


CONCLUSIONS
Patients with type C, D, or E fractures and those with greater skeletal injury scores are more likely to have fair or poor results due to the open nature of the fracture and to increased involvement of the knee joint. Although there is not an ideal method, rigid internal fixation seems to be more appropriate in fractures other than type 3 open tibia fractures.
Arslan
Hüseyin
H
Dicle Universitesi Tip Fakültesi Ortopedi ve Travmatoloji Anabilim Dali. diclehuseyin@hotmail.com
Kapukaya
Ahmet
A
Kesemenli
Cumhur Cevdet
CC
Necmioğlu
Serdar
S
Subaşi
Mehmet
M
Coban
Vafi
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014421:Turkey
Yirmi dört olguda ipsilateral femur ve tibia kiriği: Erişkinlerde "floating knee"