Functional and Radiological Outcomes in Ipsilateral Femur and Tibiafractures (Floating Knee)

Fractures of the ipsilateral femur and tibia has variable results depending on modes of treatment. The aim of our study is to evaluate clinical, functional and radiological outcomes of these injuries, managed surgically. Patients presenting with floating knee injuries from the year 2011 to 2014 were included in the study. After detailed clinical and radiological assessment of injured limb, definitive fixation of the floating knee was done according to classification type and fracture morphology. Assessment of the end result was done based on the Karlstrom criteria after bony union. Fifty-two patients were treated,out of which18 patients had open fractures and 34 were closed. Mean duration of follow up was 2.3 yearswith mean duration of radiological union for tibia was 17.8 weeks and for femur was 21.8 weeks. Non-union of femur was seen in 2 patients, with tibial non-union in 4 patients. Best outcomes are obtained with intramedullary nailing of both the fractures.The higher incidence of ligament injuries in type 2 floating knees requires routine MRI evaluation and poor results were obtained in type 2 floating knees even after appropriate treatment. We have obtained excellent results by fixing the tibia first.