Management of Floating Knee Injuries
Summary
Floating knee injuries, defined by ipsilateral fractures of the femur and tibia, arise primarily from high‐energy trauma and constitute a complex orthopaedic challenge. Management hinges on precise classification, commonly using Fraser criteria, and on an integrated approach that addresses both osseous and soft‐tissue damage. Definitive stabilisation often employs intramedullary nailing for diaphyseal fractures, bridge plating for metaphyseal or periarticular patterns, and external fixation in cases of extensive tissue compromise or open wounds. A central debate concerns early total care versus staged damage control orthopaedics, balancing accelerated functional recovery against the risk of systemic complications in polytrauma patients. Multidisciplinary assessment—encompassing vascular, ligamentous and neurologic evaluation—combined with timely surgical intervention and structured rehabilitation protocols, underpins advances in joint mobility and long‐term outcomes. Tailoring the timing and method of fixation to patient physiology and injury severity remains the bedrock of effective management worldwide.
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Management of Floating Knee Injuries publication trend
The graph below shows the total number of articles in management of floating knee injuries across all publications each year (not limited to Nature Index journals).
Technical terms
Floating knee injury: Concomitant ipsilateral fractures of the femur and tibia resulting from high‐energy trauma.
Ipsilateral fractures: Fractures occurring on the same limb.
Intramedullary nailing: A surgical technique in which a rod is inserted into the marrow canal of a bone to provide internal stabilisation.
Damage control orthopaedics (DCO): A staged surgical strategy that prioritises physiological stabilisation before definitive fracture fixation.
Early total care (ETC): Definitive surgical fixation of major fractures during the initial treatment phase to facilitate early mobilisation.
References
- Advances in Understanding and Managing Floating Knee Injuries: A Comprehensive Review. Cureus (2024).
- Early Total Care Versus Damage Control Orthopedics in Floating Knee Injury: Analysis of Radiological and Functional Outcomes. Cureus (2022).
- The current issues and challenges in the management of floating knee injury: a retrospective study. Frontiers in Surgery (2023).
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