Surgical Management of Ipsilateral Fracture of the Femur and Tibia in Adults (the Floating Knee): Postoperative Clinical, Radiological, and Functional Outcomes

BACKGROUND: This study evaluated the outcomes of surgical management of ipsilateral femoral and tibial fractures in adults. METHODS: Fifteen patients (13 men, 2 women; mean age, 34.8 years; range, 18 to 65 years) were enrolled in this study. The fractures types were classified according to the classification by Fraser et al. as follows: type I (5), type IIa (3), IIb (4), IIc (3). Femur fractures were treated using locked intramedullary nails, plate-screws, or dynamic condylar screws, and tibia fractures were treated with an external fixator (in open fractures), or plate-screws, and locked intramedullary nailing. The mean follow-up duration was 2.2 years (range, 1.3 to 4 years). RESULTS: The extent of bony union according to the Karlstrom criteria was as follows: excellent, 8; good, 4; acceptable, 2; poor, 1. CONCLUSIONS: The associated injuries and type of fracture (open, intra-articular, comminution) are prognostic factors in a floating knee. The best management of the associated injuries for good final outcome involves intramedullary nailing of both the fractures and postoperative rehabilitation.

Wrist arthrodesis with dynamic compression plates in patients with post-traumatic arthritis

24 total wrist fusions were performed in a 2 years period [1998-2000], using DCP compression plates. The mean age of the patients at the time of surgery was 42 years [range. 28-64 years]. The indication for fusion was post-traumatic arthritis in all patients. The mean follow-up was 14 months [range 9-25 months]. All the patients had united, a successful union at an average of 10.3 weeks postoperatively [range 9-14 weeks]. All the patients were evaluated using a questionnaire to assess pain, function, ability to perform an occupation and satisfaction with The Buck-Gramcko and Lohmann score [1] for functional evaluation, and it showed that 22 patients [91.7%] achieved excellent or good results with regard to their current condition and clinical improvement. Two patients [8.3%] required secondary surgery, because they were not improved and the pain was not relieved