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Carta S, Riva A, Fortina M, et al. The Challenges of the Femoral Bone Loss in the Management of the Floating Knee IIB According Fraser: A Case Report. J Orthop Case Rep. 2018;8(1):3-7doi: 10.13107/jocr.2250-0685.972.
Carta, S., Riva, A., Fortina, M., Colasanti, G. B., & Meccariello, L. (2018). The Challenges of the Femoral Bone Loss in the Management of the Floating Knee IIB According Fraser: A Case Report. Journal of orthopaedic case reports, 8(1), 3-7. https://doi.org/10.13107/jocr.2250-0685.972
Carta, Serafino, et al. "The Challenges of the Femoral Bone Loss in the Management of the Floating Knee IIB According Fraser: A Case Report." Journal of orthopaedic case reports vol. 8,1 (2018): 3-7. doi: https://doi.org/10.13107/jocr.2250-0685.972
Carta S, Riva A, Fortina M, Colasanti GB, Meccariello L. The Challenges of the Femoral Bone Loss in the Management of the Floating Knee IIB According Fraser: A Case Report. J Orthop Case Rep. 2018 Jan-Feb;8(1):3-7. doi: 10.13107/jocr.2250-0685.972. PMID: 29854682; PMCID: PMC5974666.
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J Orthop Case Rep. 2018 Jan-Feb;8(1):3-7. doi: 10.13107/jocr.2250-0685.972.

The Challenges of the Femoral Bone Loss in the Management of the Floating Knee IIB According Fraser: A Case Report.

Journal of orthopaedic case reports

Serafino Carta, Alberto Riva, Mattia Fortina, Giovanni Battista Colasanti, Luigi Meccariello

Affiliations

  1. Department of Orthopedics and Traumatology, University of Siena, University Hospital "Santa Maria Alle Scotte," Siena, Italy.
  2. Department of Orthopedics and Traumatology, Ente Ospedaliero Ospedali Galliera, Genova, Italy.
  3. Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy.

PMID: 29854682 PMCID: PMC5974666 DOI: 10.13107/jocr.2250-0685.972

Abstract

INTRODUCTION: This case report describes the management and the possible therapeutic solutions for the treatment of femoral bone loss associated with an open fracture IIIB Gustilo Andersonin a polytrauma that includes floating knee (GF) Fraser IIB from damage control orthopedics to final treatment.

CASE REPORT: The patient was treated with an external fixator femorotibial bridge after extensive cleaning and debridement of open fractures. After 17-day post-trauma, we substitute the fixator with a less invasive stabilization system plate and screws with contralateral allograft bone strut.3months after the first surgery, the patient underwent surgery for the intramedullary nailing of the tibia. The follow-up was clinical using the knee injury and osteoarthritis outcome score (KOOS), short form 12 health survey (SF-12) for quality of life, and radiological at 1-3-6-12-18-24-36 months. The patient walked with partial load up until the 6months after injury and then began a progression to a total load. At 24-months post surgery, the patient had both the KOOS and SF-12 at 100 points.

CONCLUSION: Not all Fraser IIB are equal, the timing of treatment should be discussed case by case. The surgical sequence should be respected: First, the fixation of the femur, and then, the stabilization of the tibia, taking into account the condition of the skin, eventual exposure or the eventual level of sub-amputation of the limb. The clinical and radiographic results show how efficient damage can lay the foundations for an excellent definitive treatment.

Keywords: Bone loss; bone allograft strut; bone reimplant; external fixation; floating knee; outcomes

Conflict of interest statement

Conflict of Interest: Nil

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