TO COMPARE THE FUNCTIONAL OUTCOME IN PATIENTS OF FLOATING KNEE WITH AND WITHOUT MRI
DOI:
https://doi.org/10.22159/ijcpr.2024v16i5.5074Keywords:
Floating knee, Ipsilateral femur and tibia, Ligament injury, Classification for floating knee, MRIAbstract
Objective: A floating knee injury involves simultaneous ipsilateral fractures of the femur and tibia, which disconnect the knee from the rest of the limb and can include both intra-articular and extra-articular fractures. Optimal clinical outcomes are achieved through surgical stabilization of both fractures and early rehabilitation. Historically, the incidence of floating knee injuries has been underestimated, but the use of Magnetic Resonance Imaging [MRI] and arthroscopy has increased their detection. Soft tissue injuries associated with these fractures can be missed during clinical examination due to tenderness and swelling, making immediate MRI scans a valuable diagnostic tool. This study aimed to compare the functional outcomes of patients with floating knee injuries who underwent MRI for soft tissue injuries and those who did not undergo MRI.
Methods: The study, conducted at a tertiary care center from May 2021 to April 2024, involved 100 patients with floating knee injuries who underwent MRI assessments for soft tissue injuries. Additionally, a retrospective analysis was performed on 25 patients treated between November 2018 and October 2020, who did not receive MRI evaluations. The functional outcomes for all patients were assessed using the Karlstrom Olerud criteria.
Results: Out of the 100 patients with floating knee injuries who underwent MRI, seventy-two were found to have meniscus or ligament injuries. According to the Karlstrom and Olerud criteria, the outcomes were as follows: 10 patients (8%) had excellent results, 56 patients (44.8%) had good results, 36 patients (36%) had fair results, and 6 patients (4.8%) had poor outcomes. Patients who underwent MRI had better functional outcome at 1 y and 2 y follow-up.
Conclusion: Our aim is to initiate timely and accurate treatment by comprehensively addressing all associated injuries, including previously overlooked ligament damage around the knee. Factors such as articular involvement, soft tissue damage, and the presence of concomitant injuries significantly influence functional outcomes. MRI plays a crucial role in diagnosing associated soft tissue injuries, allowing for immediate intervention and resulting in better functional outcomes.
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