Prevalence and patterns of floating knee injury among patients with major musculoskeletal injuries seen at Mulago National Referral Hospital

Abstract

Introduction; Floating knee injury result from high energy trauma and are usually associated with injuries to other body parts. Therefore, performing a thorough evaluation to assess the associated injuries reduces missed injuries rate. Literature highlights floating knee injury as “more than what meets the eye. Methodology; This cross-sectional study with 543 major MSS injuries patients admitted at MNRH from August to October 2021 were included. 57 study subjects with FKI were evaluated according to demographics, injury mechanism, clinical and radiological presentations and associated injuries. Chi square test was used for bivariate analysis and all factors with p-value <0.2 at bivariate analysis were entered for multivariate analysis Results; The prevalence of FKI in MNRH was 10.5%. Majority of the FKI cases were males 77.2% (n=44). Fraser type 1, IIA, IIB and IIC were 47.4%, 26.3%, 10.5% and 15.8% respectively. Average age of FKI patients was 30.9. RTC was the leading cause of injury with motorcycle leading by 78.9%. Open fracture (61.4%) was the commonest presentation of FKI. 82.5 % of FKI patients had associated injuries. Other extremity injuries and head injuries were the leading associated injuries 56.1% and 49.1% respectively. Conclusion. The prevalence of FKI was 10.5%, Productive age group, males were affected most Majority of FKI patients 61.4% had open fracture. Extremity and head injuries were the most associated injuries. Fraser type I was the commonest pattern. RTC was the leading cause of FKI with motorcycle taking the majority. Injury mechanism and associated extremity injuries had an association with getting FKI of higher grade. Recommendations. The attending clinicians should perform exhaustive evaluation of patients with FKI so that other injuries are not missed as majority of them were found to have associated injuries. Supportive investigation like CT in A & E is required to ensure every patient with FKI is investigated for associated injuries so that they are addressed timely. Multidisciplinary approach in the management should be considered for every patient with FKI in A&E before consultation. Administration should plan and allocate resources needed for early definitive fractures fixation to minimize complication. Large population study should be done to establish the outcomes of FKI with associated injuries.