“Floating Knees”: Epidemiological, Clinical, Therapeutic and Prognostic Study of 67 Cases

The floating knee is a simultaneous homolateral fracture of the femur and tibia separating the knee joint from the rest of the lower limb. Our work aims to study the epidemiological, clinical, therapeutic and prognostic aspects of patients with floating knee surgery in the Clinic of Traumatology and Orthopedics of Hôpital Principal Dakar (HPD), a reference trauma center from January 2008 to December 2021. We conducted a retrospective, discontinuous study that included all patients who were operated on and followed up at DMH with 67 patients with complete records. The data was entered on Epi info 7 via a computerized observation sheet and the analysis was carried out by Epi info and Excel 365. The average age of our patients was 36.58 years old with a sex ratio of 5.27. Road traffic accidents were causes of 92.53% of cases. Floating knees were open in 65.7% of cases. Floating knees were classified according to Fraser: 49.3% type I, 17.9% type IIa, 8.9% type IIb and 6% type IIc with 13 unclassifiable lesions. The floating knee was part of a polytrauma in 44.8% of cases with an average clinical severity score of 18.1. The most commonly used treatment methods were centromedullary clamping for the femur (38.8%) and external fixation for the tibia 41.8%. The functional outcomes assessed by the Karlstrom score were excellent in 16.67% of cases, good in 30% of cases, average in 30% of cases and 23.33% of poor results.