ABSTRACT
Objective To investigate the treatment strategies and clinical effects in treatment of floating knee in children.Methods A retrospective case series study was made on 26 cases of floating knee treated from July 2005 to June 2015.There were 22 males and four females, aged from 2-14 years (mean, 7.6 years).According to the Letts classification of the floating knee, ten cases were with type A, four with type B, two with type C, eight with type D, and two with type E.Closed fractures were noted in 16 cases and open fractures in 10 cases.According to the Gustilo classification of open fractures, one was with type ⅢA, six with type ⅢB, and three with type ⅢC.One case was amputated from the distal of the femur, eight cases were treated by traction and plaster caster, and 17 cases were treated by reduction and fixation of both femoral and tibil fractures.Wound healing, fracture union, Karsstrom criteria for functional outcome and complications were detected.Results All patients were followed up for mean 2.8 years (range, 1-6 years).One case of Gustilo type ⅢA and six cases of Gustilo type ⅢB open fractures had wound healing after one-stage debridement.Two cases of Gustilo type ⅢC showed wound healing after second-stage skin grafting.One case of Gustilo type ⅢC had amputation wound infection and was cured after a second debridement and dress change.Two had delayed union and there was no nonunion.According to the Karlstrom criteria, the excellent and good rate of functional outcome was 25% and 83% respectively in nonoperative and operative population (P<0.05).Malunion was found in four cases, genu vagum in three and overgrowth of 10-20 mm in seven.There was no premature closure of epiphysis.Conclusion Femur and tibia immobilization of floating knee in children is effective for bone union and functional recovery.