A study of functional outcome of surgical management of ipsilateral femur and tibia Fractures (Floating Knee Injuries).

Sivasaravanan, S (2013) A study of functional outcome of surgical management of ipsilateral femur and tibia Fractures (Floating Knee Injuries). Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Ipsilateral fractures of femur and tibia in adults are also known as floating knee Injuries . These are injuries with serious complications. High velocity trauma is a cause. Associated with extensive skeletal and soft tissue Injuries, injuries of head, chest and abdomen. Infection, excessive blood loss, maluninon, non union, knee stiffness and prolonged immobilization are the leading causes of complications . We in South India as one of the leading orthopaedic and trauma centres present our Experiences in treating floating knee injuries. AIM: To analyse the functional outcome of a group of patients sustaining ipsilateral femur and tibia fractures using Karlstrom and Olerud’s Criteria. OBJECTIVES: 1. To study the new cases, patterns and morphology of ipsilateral femur and tibia fractures, their management modalities and result. 2. To identify any modifiable factor affecting the eventual functional outcome. MATERIALS AND METHODS: This is a prospective study conducted in Department of Orthopedic Surgery, Madras Medical College, Chennai. This study is about the Functional Outcome of Surgical Managements of Ipsilateral Femur and Tibia Fractures [Floating Knee]. For this study 43 consecutive patients with Ipsilateral Femur and tibia fractures who presented to RGH casualty from May 2011- Dec 2012 who fulfilled the criteria were included but 3 patients died ,and 3 patients ended up in non union. The patients were classified according to Blake and Mcbryde’s Classification for floating knee injuries. Inclusion Criteria - 1) All ipsilateral femur and tibia fractures in adults. 2) Both closed and open fractures. Exclusion Criteria - 1) Children with ipsilateral femur and tibia fractures – skeletally immature patients. 2) Associated neurological injuries such as paraplegia or quadriplegia resulting from spinal injuries RESULTS: Non union was seen in 3 patients (6%).Further surgeries were planned in the form of LRS, Ilizarov for these patients. Malunion was observed in 6 pts (13%).Significant knee stiffness (ROM<90) was found in 11 patients (25%).Mean range of movements was 98 degrees (min 30 max 130 degrees ). Knee pain and stiffness was the most common complication in 18 patients. Limp was seen in 5 patients and laxity in 2 patients. Gait walking was unimpaired in 20 patients (46%) and only 1 patient needed to use crutches for walking. 3 patients died within the first week of admission. 28 patients required at least 1 plastic procedure (65%). Hospital stay was uncomplicated in 26 patients (60%). Superficial infection and pin site infection occurred in 11 patients (25%) and is the most common complication. Fat embolism was seen in 2 patients, ARDS in 3 patients CONCLUSION: Floating knee injuries are due to high velocity trauma. Road traffic accidents are the commonest cause. Males are affected more Right side involvement is predominant. The most important factors which determine the functional outcomes were: Type of fractures : OPEN or CLOSED, Nature of communities : Intra articular involvement, Post operative infections. Karlstrom and Olerud criteria is an effective s coring system to grade the functional outcome of floating knee injuries.

Item Type: Thesis (Masters)
Uncontrolled Keywords: functional outcome ; surgical management ; ipsilateral femur ; tibia Fractures ; Floating Knee Injuries.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 16 Sep 2017 08:31
Last Modified: 16 Sep 2017 08:31
URI: http://repository-tnmgrmu.ac.in/id/eprint/3170

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