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Floating Knee
By Arunalaya 0 Comments blog

Floating Knee

Table Of Contents

  • Introduction
  • What is a Floating Knee?
  • Types of Floating Knee Injuries
  • Complications of Floating Knee Injuries
  • Management of Floating Knee Injuries
  • Conclusion

Introduction

A floating knee is a severe injury involving fractures of both the femur (thigh bone) and tibia (shin bone) in the same leg, creating a “floating” joint. This condition, usually caused by high-energy trauma such as car accidents or falls from significant heights, was first described by Blake and McBryde in 1975. It represents a rare and complex injury requiring prompt and specialized treatment to prevent severe complications.

What is a Floating Knee?

A floating knee results from simultaneous fractures of the femur and tibia on the same leg, leading to a flail knee joint characterized by instability due to damaged supporting ligaments. This instability can cause pain, swelling, and difficulty in movement. The high incidence of open fractures, vascular injuries, and nerve damage makes this condition particularly challenging to manage.

Types of Floating Knee Injuries

Floating knee injuries have been classified using various systems to better understand and treat the condition. Here are some key classification systems:

Blake and McBryde Classification

  1. Type I: Fractures of both shafts of the two long bones.
  2. Type II-A: Fractures involving the knee joint.
  3. Type II-B: Fractures involving the hip or ankle joints.

Letts-Vincent Classification (Pediatric)

  1. Type A: Two closed diaphyseal fractures.
  2. Type B: One closed diaphyseal and one metaphyseal fracture.
  3. Type C: One diaphyseal and one epiphyseal fracture.
  4. Type D: At least one open fracture.
  5. Type E: Both fractures are open.

Bohn-Durbin Classification (Pediatric)

  1. Type I: Double shaft fractures.
  2. Type II: Juxta-articular injuries.
  3. Type III: Fractures with an epiphyseal component.

Fraser Classification

  1. Type I: Shaft fractures of both bones without knee involvement.
  2. Type II: Fractures extending into the knee.
    • Type II a: Tibial plateau involvement.
    • Type IIb: Distal femur involvement.
    • Type II c: Both tibial plateau and distal femur involvement within the knee joint.

Complications of Floating Knee Injuries

Floating knee injuries can lead to various complications, including:

  • Epiphyseal injury: May affect open growth plates in children, causing limb-length discrepancies and deformities.
  • Infections: Due to open fractures.
  • Nonunion and malunion: Improper healing of fractures.
  • Knee stiffness: Resulting in functional impairment.

Management of Floating Knee Injuries

Immediate medical attention and stabilization are critical for patients with floating knees to prevent further damage and address associated injuries. Treatment typically involves surgical stabilization of the fractures, followed by a comprehensive rehabilitation program.

Physiotherapy Rehabilitation

  • Post-surgical Examination: Assess range of motion and stability.
  • Ligament Reconstruction: Usually delayed until skeletal injury rehabilitation is adequate.
  • Pain Control: Essential in the early postoperative phase, often managed with epidural catheters or systemic opioid infusion.
  • Weight Bearing:
    • Type I: Delayed until callus formation is visible on radiographs.
    • Type II: Permitted only after 10 weeks.
  • Early Mobilization: Crucial for optimal recovery, especially in cases involving intra-articular fractures.

Conclusion

Floating knee injuries represent a complex and severe form of trauma requiring prompt, specialized medical intervention and comprehensive rehabilitation. Understanding the types, complications, and management strategies for floating knees is essential for healthcare providers to ensure the best possible outcomes for patients. With proper treatment and rehabilitation, patients can regain function and mobility, minimizing long-term complications.

 

“At Arunalaya Healthcare, we pride ourselves on being the best physiotherapy center in Delhi. Our dedicated team of experts offers top-notch physiotherapy treatment tailored to your needs. Experience the difference with the leading physiotherapy clinic in Delhi area. Our commitment to excellence ensures that you receive the best physiotherapy care possible. Trust Arunalaya Healthcare for the best physiotherapy treatment in Delhi. Our advanced physiotherapy solutions set us apart as the premier choice for your rehabilitation needs. When it comes to physiotherapy, our center stands out as the best in Delhi. Choose Arunalaya Healthcare for comprehensive physiotherapy solutions that deliver results. Visit Arunalaya Healthcare today and discover why we are the best physiotherapy center in Delhi.”

 

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By Arunalaya 0 Comments blog

How to Restore Knee Extension Range of Motion After ACL Reconstruction.

Table Of Contents

  • Introduction
  • Some of The Most Important and Simple Exercises to Improve Knee Extension Range Following ACL Reconstruction
  • Tips to Consider
  • Conclusion

Introduction

Knee extension deficit or loss of extension is a potential complication following ACL reconstruction. Lack of full extension after an ACL rupture may contribute to functional deficits and an increased risk of osteoarthritis. Loss of terminal extension often occurs because of hamstring contracture and quadriceps inactivation. Failure to regain full extension during the first few weeks may pose a risk for adverse long-term outcomes, making it crucial to address the problem at the earliest.

Some of The Most Important and Simple Exercises to Improve Knee Extension Range Following ACL Reconstruction

  1. Heel Raise
    • One of the best, most passive ways to work on extension is by sitting with your leg and raising your heel.
  2. Quads Squeeze with Heel Raise
    • Sit straight and try to lay your leg flat and wrap a towel around your heel. As you squeeze your quad, try to pull the towel up to help straighten your leg. Hold for 30-60 seconds and relax.
  3. Elevated Leg Extensions on Chair
    • Sit on one chair across from another chair of the same height. Straighten your leg so that your heel is on the heel across from you, and make sure there is no chair under your knee.
  4. Prone Hang
    • Lay on your stomach on a bed or table, with the end of the surface hitting the quad just above the knee. Relax and let your leg straighten.
  5. Walking Straight
    • Your walking is really important for ROM. As you walk, put your leg all the way straight. Try walking backwards as well to straighten the leg with motion.
  6. Terminal Knee Extension with Band
    • This is a great exercise for knee extension. Attach a band to something stationary, step into the band, placing it on the hamstring just above your knee. Push your knee back against the band to straighten your leg as much as possible.
  7. Squats with Calf Raises
    • While squatting, try to come up on your toes and go into a calf raise while pushing your leg as much as possible.
  8. Hamstring Stretch
    • Do at least 3-4 times, holding for 30-60 seconds.
  9. Slant Board
    • Use a slant board to elongate your calves and push your knee as straight as possible. Hold for 30-60 seconds and as you improve extension, select a more and more steep slant board.

Tips to Consider

  1. You must complete the exercises for knee extension several times a day.
  2. Listen to your body.
  3. Don’t overstretch.
  4. Don’t neglect flexion. Work on both types of ROM.

Conclusion

Restoring knee extension range of motion after ACL reconstruction is crucial to prevent functional deficits and long-term complications like osteoarthritis. By incorporating simple exercises such as heel raises, quad squeezes, elevated leg extensions, prone hangs, walking straight, terminal knee extensions with bands, squats with calf raises, hamstring stretches, and using a slant board, patients can improve their knee extension. It’s essential to follow these exercises diligently, listen to your body, avoid overstretching, and not neglect flexion exercises to achieve the best outcomes in restoring knee function.

 

“At Arunalaya Healthcare, we pride ourselves on being the best physiotherapy center in Delhi. Our dedicated team of experts offers top-notch physiotherapy treatment tailored to your needs. Experience the difference with the leading physiotherapy clinic in Delhi area. Our commitment to excellence ensures that you receive the best physiotherapy care possible. Trust Arunalaya Healthcare for the best physiotherapy treatment in Delhi. Our advanced physiotherapy solutions set us apart as the premier choice for your rehabilitation needs. When it comes to physiotherapy, our center stands out as the best in Delhi. Choose Arunalaya Healthcare for comprehensive physiotherapy solutions that deliver results. Visit Arunalaya Healthcare today and discover why we are the best physiotherapy center in Delhi.”

 

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