An Epidemiological Profile and Management of Floating Knee at the Traumatology and Orthopedics Department (Section A) of Hassan II Hospital, Fez/Morocco

Present study highlights the epidemiological profile and management of floating knee at the traumatology and Orthopedics department (section A) of Hassan II Hospital, Fez/Morocco. The floating knee is an association of ipsilateral femur and tibia fractures first described by BLAKE and MCBRYDE in 1974. The study retrospectively reviewed the cases of 32 patients who were operated between January 2009 and November 2018. We only included patients with a floating knee. Staging and indexing both used Frazer's classification. Open fractures were evaluated preoperatively for severity of related injuries using the Injury Severity Score and the Cauchoix-Duparc classification. Functional outcomes were assessed use the Karlstrom and Olerud criteria. Young active adults were the most affected with a mean age of 28 years and a clear male predominance (90.62%). Road accidents were the main cause (93.75%).

According to Fraser's classification, 68.75% of cases were type I, type IIa (15.62 %), type IIb (9.37%) and type IIc (6.25%). Seventeen patients underwent IM nailing of both femur and tibia fractures. Four patients (12.5%) underwent ORIF with DCP femur plate; 3 patients (9.37%) underwent condylar plate bridging of the femur; whereas 2 patients (6.25%) underwent ORIF of tibia with DCP plate and 2 patients (6.25%) with T-buttress plate of the tibial plateau. The advent of several modes of transport coupled with the growth of the automobile industry and especially the non-compliance with the road safety regulations are largely to blame for the surge in road traffic accidents. In Morocco, RTA’s are the main etiology of floating knees.

The floating knee is a condition that is slowly spreading over our side of the world and mostly affects young, active folks. Most typically, radio-clinical diagnosis is used. A skilled interdisciplinary team should carry out management because it is operational.