Lower limb fractures like floating knees are more common in urban areas of low-income countries. In addition, associated complex lesions are manifestations of polytrauma requiring correct and appropriate management. T...Lower limb fractures like floating knees are more common in urban areas of low-income countries. In addition, associated complex lesions are manifestations of polytrauma requiring correct and appropriate management. The treatment is mostly surgical. We present a 19-year-old patient with a floating knee due to ipsilateral femoral and tibial fractures and vascular compression treated with femoral and calcaneus traction followed by a long limb cast. For our patient, the management of the concomitant vascular compression threatening vital and functional prognosis was in focus aiming at avoiding a radical decision such as limb amputation. The non-operative treatment managed to restore the blood supply and save the limb. At the follow-up after 10 months the fractures were clinically healed and radiologically consolidated and the walking capacity was almost restored. Non-surgical treatment accompanied by daily monitoring can prevent the radical solution of amputation in the context of a floating knee with vascular compression. We want to draw attention to the weakness of the existing classifications because they do not take into account vascular lesions as well as the presence of open fractures to define the severity and evaluate the prognosis.展开更多
文摘Lower limb fractures like floating knees are more common in urban areas of low-income countries. In addition, associated complex lesions are manifestations of polytrauma requiring correct and appropriate management. The treatment is mostly surgical. We present a 19-year-old patient with a floating knee due to ipsilateral femoral and tibial fractures and vascular compression treated with femoral and calcaneus traction followed by a long limb cast. For our patient, the management of the concomitant vascular compression threatening vital and functional prognosis was in focus aiming at avoiding a radical decision such as limb amputation. The non-operative treatment managed to restore the blood supply and save the limb. At the follow-up after 10 months the fractures were clinically healed and radiologically consolidated and the walking capacity was almost restored. Non-surgical treatment accompanied by daily monitoring can prevent the radical solution of amputation in the context of a floating knee with vascular compression. We want to draw attention to the weakness of the existing classifications because they do not take into account vascular lesions as well as the presence of open fractures to define the severity and evaluate the prognosis.
