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Портал Begell Электронная Бибилиотека e-Книги Журналы Справочники и Сборники статей Коллекции
Journal of Long-Term Effects of Medical Implants
SJR: 0.145 SNIP: 0.491 CiteScore™: 0.89

ISSN Печать: 1050-6934
ISSN Онлайн: 1940-4379

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Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2019030557
pages 1-6

Bilateral Floating Knee Injury—Management of a Complex Injury

Alexandros P. Apostolopoulos
Trauma and Orthopaedic Department, "Korgialenio-Benakio" Hellenic Red Cross Hospital, Athens, Greece; Trauma and Orthopaedic Department, Ealing Hospital, North West University Healthcare NHS Trust, London, United Kingdom
Stavros Angelis
Trauma and Orthopaedic Department, Prince Charles Hospital, London, UK
Salma E. Elamin
Trauma and Orthopaedic Department, Prince Charles Hospital, London, UK
Glenn Clewer
Trauma and Orthopaedic Department, Prince Charles Hospital, London, UK

Краткое описание

Floating knee is a flail knee joint resulting from fractures of the shafts or adjacent metaphyses of the femur and ipsilateral tibia. Floating knee injuries may include a combination of diaphyseal, metaphyseal, and intra-articular fractures. Floating knee injuries are a group of complex injuries that require a careful assessment. This injury is generally caused by high-energy trauma with often extensive trauma to the soft tissues. There may also be life-threatening injuries to the head, chest, or abdomen and a high incidence of fat embolism. This complex injury has increased in proportion to population growth, number of motor vehicles on the road, and high-speed traffic. Although the precise incidence of a floating knee is not known, it is a relatively uncommon injury. Bilateral floating knee injuries are extremely rare, and there is only one case report in the literature with bilateral floating knee injuries. We present a case report of a 64-year-old lady who suffered a blunt abdominal injury (hemicolectomy and splenectomy) and bilateral floating knees during road traffic accident. We also offer guidance for the treatment of this complex injury, based on literature review.

Ключевые слова: polytrauma patient, floating knee, damage control


  1. Fraser RD, Hunter GA, Waddell JP. , Ipsilateral fracture of the femur and tibia. J Bone Joint Surg Br. 1978;60(4):510–15.

  2. Blake R, McBryde A. Jr. , The floating knee: ipsilateral fractures of the tibia and femur. South Med J. 1975;68:13–16.

  3. Karlstrom G, Olerud S. , Ipsilateral fracture of the femur and tibia. J Bone Joint Surg Am. 1977;59:240–43.

  4. Hung SH, Lu YM, Huang HT, Lin YK, Chang JK, Chen JC, Tien YC, Huang PJ, Chen CH, Liu PC, Chao D., Surgical treatment of type II floating knee: comparisons of the results of type IIA and type IIB floating knee. Knee Surg Sports Traumatol Arthrosc. 2007;15:578–86.

  5. Yokoyama K, Tsukamoto T, Aoki S, Wakita R, Uchino M, Noumi T, Fukushima N, Itoman M. , Evaluation of functional outcome of the floating knee injury using multivariate analysis. Arch Orthop Trauma Surg. 2002;122:432–35.

  6. Arslan H, Kapukaya A, Kesemenli CC, Necmioğlu S, Subaşi M, Coban V. , The floating knee in adults: twenty-four cases of ipsilateral fractures of the femur and the tibia. Acta Orthop Traumatol Turc. 2003;37:107–12.

  7. Hee HT, Wong HP, Low YP, Myers L. , Predictors of outcome of floating knee injuries in adults: 89 patients followed for 2–12 years. Acta Orthop Scand. 2001;72:385–94.

  8. Rethnam U, Yesupalan RS, Nair R. , The floating knee: epidemiology, prognostic indicators and outcome following surgical management. J Trauma Manag Outcome. 2007;1:2.

  9. Giannoudis PV, Tzioupis C, Green J. , Surgical techniques: how I do it? The Reamer/Irrigator/Aspirator (RIA) system. Injury. 2009 Nov;40(11):1231–36.

  10. Giannoudis PV, Tan HB, Perry S, Tzioupis C, Kanakaris NK. , The systemic inflammatory response following femoral canal reaming using the reamer-irrigator-aspirator (RIA) device. Injury. 2010 Nov;41(Suppl 2):S57–S61.

  11. Schreiber MV, Tarkin I, Hildebrand F, Darwiche S, Pfeifer R, Cheely J, Giannoudis PV, Pape H., The timing of definitive fixation for major fractures in polytrauma. A matched pair comparison between a US and European level I centres: analysis of current fracture management practise in polytrauma. Injury. 2011;42:650–54.

  12. Goris RJ, Gimbrere JS, Niekerk JL. , Early osteosynthesis and prophylactic mechanical ventilation in the multitrauma patient. J Trauma. 1982;22:903.

  13. Giannoudis PV, Smith RM, Bellamy MC. , Stimulation of the inflammatory system by reamed and unreamed nailing of femoral fractures. JBJS Br. 1999;81:356–61.

  14. Rixen D, Grass G, Sauerland S., Evaluation of criteria for temporary external fixation in risk adapted damage control orthopaedic surgery of femur fractures in multiple trauma patients: evidence based medicine versus reality in the trauma registry of German trauma society. J Trauma.

  15. Gugenheim JJ, Probe RA, Brinker MR. , The effects of femoral shaft malrotation on lower extremity anatomy. J Orthop Trauma. 2004 Nov–Dec;18(10):658–64.

  16. Tornetta P, Ritz G, Kantor A. , Femoral torsion after interlocked nailing of unstable femoral fractures. J Trauma. 1995;38:213–19.

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