Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 64 7 2026 07 12 443 446 Shahin Talebi Musculoskeletal Injuries Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Salman Ghaffari Department of Orthopedic Surgery, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Mohammad Tehrani Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Akbar Ehsani Musculoskeletal Injuries Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Reza Zandi Musculoskeletal Injuries Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2023 10 19 2025 04 03  Ipsilateral femur and tibia fractures (floating knee injury) is a complex injury with severe associated injuries. The aim of this study was to assess the characteristics and treatment outcomes in patients with floating knee in a single trauma center. A retrospective study was conducted among patients with floating knee treated between January 2012 and January 2019 in a single trauma center. Patients with knee osteoarthritis, inflammatory arthritis, pathologic fracture, and with a history of previous fracture in ipsilateral leg were excluded. Data demographics, associated injuries, complications, and treatment outcome were collected. Karlstrom’s criteria were used to assess the results. We identified 48 patients aged 18 to 50 years old. All patients sustained a road traffic accident. Fraser type 1 was the most frequent type (62.5%). Open fracture reported in 25 cases (52.1%) at least in one bone. According to Karlstrom’s criteria, 8 cases (16.67%) with excellent results, 19 cases (39.58%) with good results, 14 cases with (29.17%) fair results, and 7 cases (14.58%) poor results were reported. Floating knee injury occurs in a high energy trauma context. Complication rate remains high, and surgeons should focus on reducing these complications. https://acta.tums.ac.ir/index.php/acta/article/view/10844 https://acta.tums.ac.ir/index.php/acta/article/download/10844/6075