Missile injuries of the knee joint

The results of the treatment of missile injuries of 170 knees in 162 patien ts are analyzed. The injuries were caused by infantry weapon missiles in 52 (32.1%) and by fragments of mine or explosive devices in 110(67.9%) patient s. The most frequent were penetrating injuries of the joint with multifragm ent fractures which in 15.8% cases were associated with injuries of the neu rovascular bundle. Stabilization of bone fragments was required in 111(65.3 %) knees. Stabilization was done by external fixation in 42(37.8%) and by p laster of Paris in 69(62.2%) knees. Additional mini osteosynthesis was requ ired in 13(30.9%) knees stabilized by external fixation and in 3(4.3%) knee s stabilized by plaster of Paris. Amputations were performed in 13(7.6%) in jured knees. During the postoperative period local and general complication s occurred in 27(16.6%) patients. The most frequent local complications wer e suppurative articular infections requiring repeated surgery. Soft tissue defect covering was necessary in 53(33.1%) patients. The poor late results were present in missile fractures of the knee. The most frequent were degen erative changes with bone defects. The possible surgical solutions in such cases are arthrodesis or total endoprosthesis implantation. (C) 2000 Elsevi er Science Ltd. All rights reserved.