The floating knee in adults. Twenty-four cases of ipsilateral fractures of the femur and the tibia

Huseyin Arslan; Ahmet Kapukaya; Cumhur Kesemenli; Serdar Necmioglu; Mehmet Subasi; Vafi Coban

Article Details

The floating knee in adults. Twenty-four cases of ipsilateral fractures of the femur and the tibia

Authors:

Huseyin Arslan | Ahmet Kapukaya | Cumhur Kesemenli | Serdar Necmioglu | Mehmet Subasi | Vafi Coban

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2003 Vol.37 Issue 2, pp.107-112

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000812915

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X

Keywords:

Abstract:

 

Objectives: 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.
Conclusion: 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.

 

Amaç: Erişkinlerde karşılaşılan ipsilateral femur ve tibia kırıklarının özellikleri ve kırığın tipinin ve iskeletsel yaralanma derecesinin sonuçlara olan etkisi değerlendirildi.
Çalışma planı: Çalışmaya 24 hasta (22 erkek, 2 kadın; ort. yaş 38; dağılım 17-75) alındı. Letts ve ark.nın sınıflandırmasına göre kırıkların yedisi tip A, ikisi tip B, beşi tip C, yedisi tip D, üçü tip E olarak belirlendi. Femur kırıkları kilitli intramedüller çivi, AO plak, düz plak-vida, tek taraflı eksternal fiksatör veya dinamik kondiler vida ile tedavi edildi. Tibia kırıkları ise eksternal fiksatör, plak-vida, intramedüller kilitli çivileme ya da konservatif yöntemle tedavi edildi. Tip 3C açık tibia kırığı olan bir hastaya kırık seviyesinde amputasyon yapıldı. Hastalar ortalama 3.2 yıl (dağılım 1.3-7 yıl) izlendi.
Sonuçlar: Kalström ve Olerud’un ölçütlerine göre üç hastada mükemmel, dokuz hastada iyi, beş hastada yetersiz, altı hastada kötü sonuç alındı. Ekstremite yaralanma derecesi, yetersiz ve kötü sonuç alınan hastalarda 4.4, iyi ve mükemmel sonuç alınanlarda 3 bulundu. Yetersiz ve kötü sonuç alınan bir hastada tip A, diğerlerinde ise C, D veya E tipinde kırık olduğu gözlendi. Tibiasında tip 3 açık kırığı olan beş hastada yetersiz veya kötü sonuç alındı. On üç hastada (%54) en az bir komplikasyon oluştu.
Çıkarımlar: Açık ve diz eklemiyle ilişkili olmaları nedeniyle tip C, D ve E kırıklarda ve iskeletsel yaralanma derecesi yüksek hastalarda yetersiz ve kötü sonuç daha fazla görülmektedir. Tedavide ideal bir tespit yöntemi olmamakla birlikte, sıkı internal fiksasyon, tip 3 tibia açık kırıkları dışında tercih edilmelidir.

Article Details

The floating knee in adults. Twenty-four cases of ipsilateral fractures of the femur and the tibia

Authors:

Huseyin Arslan | Ahmet Kapukaya | Cumhur Kesemenli | Serdar Necmioglu | Mehmet Subasi | Vafi Coban

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2003 Vol.37 Issue 2, pp.107-112

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000812915

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X

accidents

traffic;adult;femoral fractures/surgery;femoral fractures/complications;fracture fixation

internal/methods;fracture fixation

intramedullary/methods;knee injuries;Knee joint;multiple trauma/ surgery;tibial fractures/surgery;tibial fractures/c

Issues

Article Details

The floating knee in adults. Twenty-four cases of ipsilateral fractures of the femur and the tibia

Authors: Huseyin Arslan | Ahmet Kapukaya | Cumhur Kesemenli | Serdar Necmioglu | Mehmet Subasi | Vafi Coban

Publisher: Turkish Association of Orthopaedics and Traumatology

Journal: Acta Orthopaedica et Traumatologica Turcica 2003 Vol.37 Issue 2, pp.107-112

Document Type: Article

Publication Date: 9/2006

Document Language: English

Document ID (Org No.): 2000812915

Frequency: Bimonthly

eISSN: 1017-995X

pISSN: 1017-995X

accidents

traffic;adult;femoral fractures/surgery;femoral fractures/complications;fracture fixation

internal/methods;fracture fixation

intramedullary/methods;knee injuries;Knee joint;multiple trauma/ surgery;tibial fractures/surgery;tibial fractures/c

Issues

Authors:

Huseyin Arslan | Ahmet Kapukaya | Cumhur Kesemenli | Serdar Necmioglu | Mehmet Subasi | Vafi Coban

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2003 Vol.37 Issue 2, pp.107-112

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000812915

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X