A Case Report of Ipsilateral Multiple Long Bone Fractures with a Floating Knee Complicated by Compartment Syndrome: A Single-Theater Session, a Panacea for Early Mobilization and Rehabilitation
DOI:
https://doi.org/10.60787/njgp.v16i1.104Keywords:
multiple fractures, long bones, ipsilateral, floating knee, Compartment syndromeAbstract
An ipsilateral femoral and segmental tibial fracture with floating knee is a complex injury that could occur following a fall from height and
a compartment syndrome further complicates it. This report highlights the need for the availability of ready implant pack for the emergency surgical management of a complex injury in a single-theater session. A 15-year-old male presented to our level II surgical facility after a fall from the balcony of the 5th floor of a storey building. Clinical evidence of fractures of the left femur and tibia associated with flail knee was noted in addition to early features of compartment syndrome of the leg. Fasciotomy as well as internal fixations of the fractures followed by a quick, uneventful recovery was performed. The severity and type of injuries sustained from accidental falls from heights depend on the height of fall, the pattern of landing, and the hardness of the impact surface. Fractures associated with floating knee and compartment syndrome should be treated as surgical emergency, and the availability of a ready implant pack is absolutely necessary for full intervention in one theater session. Emergency combination of fasciotomy and internal fixation of fractures in floating knee ensures early mobilization and reduces the length of hospital stay.
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References
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age
groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2095‑128.
Flynn JM, Hresko T, Reynolds RA, Blasier RD, Davidson R, Kasser J, et al. Titanium elastic nails for pediatric femur fractures: A multicenter
study of early results with analysis of complications. J Pediatr Orthop 2001;21:4‑8.
Loder RT, Feinberg JR. Orthopaedic injuries in children with nonaccidental trauma: Demographics and incidence from the 2000 kids’
inpatient database. J Pediatr Orthop 2007;27:421‑6.
Bonnevialle P, Cariven P, Bonnevialle N, Mansat P, Martinel V, Verhaeghe L, et al. Segmental tibia fractures: A critical retrospective
analysis of 49 cases. Rev Chir Orthop Reparatrice Appar Mot 2003;89:423‑32.
Agu TC, Orjiaku ME. The prevalence and pattern of acute compartment syndrome of the limbs in a private orthopedic and trauma center, South East Nigeria: 8 years retrospective study. Afr J Trauma 2016;5:10‑5.
Chalidis B, Metha SS, Tsiridis E, Giannoudis PV. Mini-symposium: Management of fractures around the knee joint, ‘the floating knee’ in
adults and children. Curr Orthop 2006;20:405‑10.
Lasanianos NG, Kanakaris NK, Dimitriou R, Pape HC, Giannoudis PV. Second hit phenomenon: Existing evidence of clinical implications.
Injury 2011;42:617‑29.
Ostrum RF. Treatment of floating knee injuries through a single percutaneous approach. Clin Orthop Relat Res 2000;375:43‑50.
Fyodorov I, Sturm PF, Robertson WW Jr. Compression‑plate fixation of femoral shaft fractures in children aged 8 to 12 years. J Pediatr Orthop
;19:578‑81.
Kao FC, Tu YK, Hsu KY, Su JY, Yen CY, Chou MC, et al. Floating knee injuries: A high complication rate. Orthopedics 2010;33:14.
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