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Dr. Eslam Abd Elshafi Mohamady Tabl :: Publications:

Title:
Neglected infected floating knee injury: evaluation of closed reduction techniques
Authors: Eslam Abdelshafi Tabl ; Gamal Ahmed Hosny ; Abdel‐Salam Abdel‐Aleem Ahmed
Year: 2021
Keywords: floating knee
Journal: European Journal of Trauma and Emergency Surgery
Volume: 48
Issue: 2022
Pages: 2331–2339
Publisher: Springer Nature
Local/International: International
Paper Link:
Full paper Eslam Abd Elshafi Mohamady Tabl_PHOTO-2020-09-10-20-30-45.jpg
Supplementary materials Eslam Abd Elshafi Mohamady Tabl_PHOTO-2020-09-10-20-30-45.jpg
Abstract:

Purpose Floating knee injury is uncommon yet challenging problem. The situation is more complicated by presence of infection, open comminuted fractures, and late presentation. The aim of this study was to evaluate the closed reduction techniques by circular external fixation in a single stage to treat patients having infected neglected floating knee injuries. Methods This retrospective study included 19 patients with a mean age of 34.4 years. The average duration from trauma to surgery was 51.1 days. All patients had at least one infected open fracture. According to Fraser’s classification, ten injuries were type I, one case was type IIa, four were type IIb, and four were type IIc. Patients were treated by closed reduction techniques using the Ilizarov principles. Orthoplastic procedures were done in four cases in the same surgical setting. Results Closed reduction and union were achieved in all cases with control of infection in 17 cases. The follow-up period averaged 41 months. The mean knee flexion was 97.4°. The complications included 5° extension lag (two cases), malunion (three cases), refracture (two cases), and DVT (four cases). The bone results were excellent (12 cases), good (5 cases), and poor (2 cases). The functional results were excellent (two cases), good (seven cases), acceptable (seven cases), and poor (three cases). Conclusions Closed reduction techniques using a circular frame provided a valid treatment option for infected neglected floating knee injuries in one stage without bone grafting. However, the high rate of complications and the diminished knee range of motion should be considered.

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