Floating Knee with Ipsilateral Fractures of Intertrochanter and Patella

浮動膝是指同側股骨及經骨的骨折，一般認為是高能量的受傷機轉，假如處理不當會導致膝關節功能喪失、骨折不癒合、截肢，甚至死亡。股骨幹骨所併同側的髖部骨折雖然不常見卻是嚴重的肢體傷害，目前在文獻上並沒有文章報導同時股骨幹、經骨、股骨轉子間骨折，髖骨骨折的案例，其受傷機轉更沒有被報導過。浮動膝的受傷機轉目前未明。同側股骨幹及髖部骨折的受傷機轉一般認為是在膝關節彎曲時股骨承受縱向力量所造成。此篇文章嘗試闡明這種複雜骨折的發生機轉，並找出簡單可遵循的治療原則。手術後功能的評估採用Karlstrom及Olerud的評分系統。這位病人的最終結果被評為好。

關鍵字

浮動膝；複雜骨折；轉子間骨折；髕骨骨折

並列摘要

Ipsilateral fractures of the femur and tibia are thought to be high-energy trauma. Inadequate treatment could result in loss of knee motion, nonunion, amputation, and even death. Ipsilateral hip and femoral fractures are serious but uncommon injuries, having a high incidence of associated fractures and ipsilateral knee injuries. There was no report of concomitant femoral shaft fracture, tibial open fracture, intertrochanteric fracture, and patellar fracture in the same extremity. The mechanism responsible for a floating knee injury is not clear. The mechanism of ipsilateral fractures of the hip and femoral shaft is thought to be that the femur is longitudinally loaded when the knee is flexed in the position of neutral adduction-abduction. Although the true mechanism should be proven by further experiments, we try to delineate the complex mechanisms in our case. After understanding the mechanism of such complex fractures, we believe that these fractures can be simplified to analyze and treat as the open floating knee injury. The functional result was evaluated using the grading system of Karlstrom and Olerud. The final result was graded as good for this patient.

並列關鍵字

floating knee ； complex fractures ； intertrochanteric fracture ； patellar fracture

國際替代計量

Floating Knee with Ipsilateral Fractures of Intertrochanter and Patella

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