Comparison of functional outcomes among subtypes of Fraser's type II floating knee

• 作者: Chouhan Deepak Chouhan Devendra K. Kanojia Rajendra K. Behera Prateek
• 来源期刊: 中华创伤杂志英文版
• 关键词: Floating knee Femur fractures Tibia fractures Outcome
• 年，卷（期）: 2021,（1）
• 所属期刊栏目: Original Article
• 页码范围: 25-29
• 页数: 5页
• 语种: 中文
• DOI: 10.1016/j.cjtee.2020.11.010

摘要

Purpose::The poor prognosis in patients with floating knee injuries is mainly contributed to articular involvement (Fraser's type II). This study aims to evaluate and compare the functional outcomes among different Fraser's type II floating knee injuries after surgical management.Methods::Twenty-seven patients with Fraser's type II floating knee injuries (54 fractures) between September 2014 and December 2015 were enrolled prospectively in this study and were distributed according to Fraser's floating knee classification into three different groups as type IIA (ipsilateral femoral shaft and tibial intra-articular involvement, n = 11), type IIB (ipsilateral tibial shaft and femoral intra-articular involvement, n = 9) and type IIC (both femoral and tibial intra-articular involvement, n = 7). The differences among the groups were evaluated and compared. The functional outcomes of these injuries at one year were analyzed using Knee Injury and Osteoarthritis Outcome Score (KOOS) which covers 5 subscales of pain, other symptoms, activities of daily living, sports and recreation, and quality of life. The result was also compared with standardized age-sex matched healthy population using paired samples t-test. Results::All the patients were male, and the injury mechanism was solely roadside accident. The mean age was 29.8 years and injury severity score 17.9 (comparable in all the three groups). Most injuries were observed on the right side (20 cases, 74.1%). Based on paired samples t-test, the KOOS score of patients with Fraser's type IIA was found to be better than that of type IIB and type IIC. Compared with the reference age-sex matched control group, patients with Fraser's type IIB and IIC fractures had significantly lower mean score in all KOOS subscales (all p < 0.01). However, Fraser's type IIA only revealed significant difference regarding the subscales of activities of daily living ( p < 0.0001), sports and recreation ( p < 0.0001), and quality of life ( p < 0.0001). Conclusion::The results of this study show that patients with Fraser's type IIA fractures had a better functional outcome as compared to those with type IIB and IIC fractures. This might be due to the open intra-articular involvement of the distal femur of the latter two fracture types.