Treatment of floating knee injuries in children

YU Tie-qiang; ZUO Yu-ming; WANG Yue-guang; YI Fan; ZHANG Lei; LIAN Xiao-jing; LI Fei; WANG Jing; ZHAO Jin

doi:10.3969/j.issn.2095-252X.2017.09.014

Abstract：Objective To investigate the treatment and clinical outcomes of floating knee injuries in children. Methods A total of 19 cases of floating knee injuries were analyzed from January 2008 to June 2014. There were 12 boys and 7 girls with an average age of 7.8 years ( range: 1 year and 4 months to 15 years ). Left side: 8 cases;right side: 10 cases; the both: 1 case. Causes of injury: traffic accident 16 cases, machine twist 1 case, bicycle falling 1 case, falling 1 case. According to modified Bohn and Durbin classification: type I 10 cases ( 11 knees ), type Ⅱ 6 cases, type Ⅲ a 3 cases. Open tibial fracture: 4 cases; open fracture of the femur and tibia: 2 cases. Three cases associated with hemorrhagic shock, 3 cases with craniocerebral injury, 1 case with blunt abdominal trauma, 10 cases with other fractures, 1 case with common peroneal nerve injury, 1 case with vascular injury, 1 case with osteofascial compartment syndrome, 2 cases with skin avulsion injury. Two cases younger than 3 years old received conservative treatment, while others received surgery. Results All patients were followed up for 12 - 48 months with an average of 18 months. All incisions healed by the first intention except for 1 case of the second healing. Fractures were healed. Peroneal nerve injury recovered completely within 8 weeks. Lower limb valgus deformity occurred in 2 cases with proximal tibial metaphyseal fractures. Unequal length of the lower limbs occurred in 1 case ( > 2 cm ). According to the evaluation criteria of Yue: 15 cases were excellent, 1 good , 2 fair, 1 poor. Conclusions Traction treatment effects are good in children < 3 years old. Surgery is an effective method for the treatment of floating knee injury in children > 3 years old. Individualized treatment plan can effectively reduce complications.