Abstract
Ipsilateral fracture of the femur and tibia, denominated as floating knee, are results of high-energy trauma related to high rates of associated injuries and complications. This case reports a type IIIA exposed floating knee, with loss of joint bone fragments of the tibia and femur during an accident. Guided by the MESS score, limb saving was performed, fragments were reinserted and joint reconstruction was performed. The patient had bone consolidation in four months, infection with fistula in the knee at six months with some improvement when treated and osteonecrosis of the reinserted fragments was observed at sixteen months (lateral femoral condyle and lateral tibial plateau). The patient maintains the arc of motion in the knee of 10-90 degrees of flexion extension, walks without crutches, but with a limp, valgus and pain. The use of scores like MESS helps in the decision to rescue or amputate severe cases, but it does not predict the functional outcome, and the floating knee is commonly associated with complications and worse case functional results, especially when it involves intra articular fractures, comminuted fractures and infection, factors that are present in this reported case.
Citation
Paschoa BGP, Sanchez GT, Franciozi CES, Balbachevsky D, dos Reis FB and Luzo MVM. Case Report: Exposed Floating Knee with Bone Loss with Primary Fixation. SM Emerg Med Crit Care. 2017; 1(2): 1009.