MIPO For Complex Comminuted Bone Fractures in the Floating Knee IIC According Fraser: a Case Report

Abstract

Objective:Floating knee type IIC according to Fraser’s classification is an uncommon severe injury that typically occurs in polytrauma. In this case, mainly due to both intraarticular fracture and the high degree of comminution and malformation on the femoral mid-distal segments, fixation was challenging. The purpose of this study was to prove that minimally invasive plate osteosynthesis (MIPO) technology can simplify complex problems and improve prognosis. Case Presentation:A 38-year-old man injured his left leg in a car accident, causing pain, swelling, deformity, and limited mobility on his left knee and thigh, and two small open wounds were noted mainly on the anterior aspect of the mid-distal thigh. Physical examination and lower limb computed tomography angiography (CTA) confirmed that the neurovascular status was normal. The clinical diagnosis were closed intraarticular fracture of the proximal tibia, open intraarticular fracture of the distal femur with extension to the diaphysis, and a patellar fracture on the ipsilateral knee.In this case, a locking plate system characterized by minimally invasive plate osteosynthesis (MIPO) technology was used as the treatment. Results and Conclusion:Postoperative evolution was satisfactory, with immediate functional exercise, full weight bearing after three months, and return to daily activity without pain. Final follow-up taken at 3 years showed good lower limb alignment and complete plasticity of the bone structure, by which time the patient showed good limb function. Minimally invasive techniques can provide a simple and effective treatment for some complex fractures.