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Neglected infected floating knee injury: evaluation of closed reduction techniques

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

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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Data availability

The data analyzed during the current study are available upon reasonable request.

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Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, Benha University, Farid Nada Street, Kalyubia, Benha, 13518, Egypt

    Gamal Ahmed Hosny, Abdel-Salam Abdel-Aleem Ahmed & Eslam Abdelshafi Tabl

Authors
  1. Gamal Ahmed Hosny
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  2. Abdel-Salam Abdel-Aleem Ahmed
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  3. Eslam Abdelshafi Tabl
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by GAH, A-SA-AA, and EAT. The first draft of the manuscript was written by A-SA-AA, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Abdel-Salam Abdel-Aleem Ahmed.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Research Ethics Committee at Faculty of Medicine, University (REC-FOMBU) approved this study.

Informed consent

An informed consent was obtained from all patients involved in the present study after explaining the details of the treatment method.

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Patients signed informed consent regarding publishing their data and photographs.

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Hosny, G.A., Ahmed, AS.AA. & Tabl, E.A. Neglected infected floating knee injury: evaluation of closed reduction techniques. Eur J Trauma Emerg Surg 48, 2331–2339 (2022). https://doi.org/10.1007/s00068-021-01745-6

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  • DOI: https://doi.org/10.1007/s00068-021-01745-6

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