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Intramedullary nailing of the tibia and femur
81%
1157/1426
External fixation of the tibia and femur
13%
181/1426
Balanced skeletal traction
1%
8/1426
Circular external fixation of the tibia and intramedullary nailing of the femur
2%
34/1426
Uniplanar external fixation of the tibia and intramedullary nailing of the femur
3%
39/1426
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Polytrauma patients with ipsilateral femoral and tibial fractures (floating knee injuries) often require aggressive hemodynamic resuscitation and immediate stabilization via external fixation following tenets of damage-control orthopaedics. However, goals for definitive management of these fractures include obtaining anatomic alignment, early joint range of motion, and early weightbearing. If the floating knee injury is an isolated injury and the patient is hemodynamically stable then immediate intramedullary nailing of the tibia and femur is acceptable. Of the choices listed, intramedullary nailing of both the femoral and the tibial fracture is the optimal form of fixation for these transverse fractures. The technique of antegrade intramedullary nailing of both the femur and the tibia has been well described. Retrograde femoral nails and antegrade tibial nails can be advantageous because it allows simultaneous surgical setup for both the femoral and the tibial fracture.
3.9
(56)
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