Abstract
Ipsilateral femur and tibial shaft fractures are uncommon in the pediatric population and frequently result from high-energy mechanisms of injury. These floating knee injuries often add significant complexity to fracture management. Many are associated with concomitant visceral, thoracic, and/or head injuries that may take precedence over definitive fracture fixation especially in the setting of hemodynamic instability. Furthermore, orthopedic surgeons must often alter implant selection, patient positioning, and choice of operative table from one’s usual practice when managing either fracture in isolation. This case highlights the management strategies of a 10-year-old male involved in a high velocity trauma who sustained a femoral neck fracture, an ipsilateral open distal third femoral shaft fracture, and an ipsilateral fracture of the tibial diaphysis. We present a management strategy to maximize fixation efficiency though reduction techniques and implant choices while addressing the specific complexities of each fracture.
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References and Suggested Reading
British Orthopaedic Association and British Association of Plastic, R. a. A. S (2007) Standards for the management of open fractures of the lower limb, London, England, UK
Pape HC, Pfeifer R (2015) Safe definitive orthopaedic surgery (SDS): repeated assessment for tapered application of Early Definitive Care and Damage Control?: an inclusive view of recent advances in polytrauma management. Injury 46(1):1–3
Vidyadhara S, Rao SK (2009) Cephalomedullary nails in the management of ipsilateral neck and shaft fractures of the femur – one or two femoral neck screws? Injury 40(3):296–303
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Green, C., Riccio, A.I. (2020). Floating Knee: Combined Femoral and Tibial Fractures. In: Iobst, C., Frick, S. (eds) Pediatric Orthopedic Trauma Case Atlas. Springer, Cham. https://doi.org/10.1007/978-3-319-29980-8_112
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DOI: https://doi.org/10.1007/978-3-319-29980-8_112
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Publisher Name: Springer, Cham
Print ISBN: 978-3-319-29979-2
Online ISBN: 978-3-319-29980-8
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