微创固定系统治疗股骨远端复杂骨折

Treatment of Complex Fractures of Distal Femur with Less Invasive Stabilization System(LISS)

目的:探讨微创固定系统(Less invasive stabilization system,LISS)治疗股骨远端复杂骨折的手术适应症及其疗效.方法:自2004年12月～2007年12月,应用LISS钢板治疗12例13处骨折.男8例,女4例;平均年龄35岁(18～60岁).其中1例为同侧股骨远端,胫骨近端骨折.手术采用间接复位(关节内骨折除外),微创切口,经骨膜外和肌肉之间插入钢板,经皮小切口将带锁定头的螺钉与钢板的螺孔锁定.结果:12例患者获6～27个月随访.所有患者均获骨性愈合.HSS评分:优8例,良2例,可1例,差1例,优良率83.3%.结论:LISS治疗股骨远端骨折具有微创、固定可靠、术后恢复和骨折愈合快的优点,是治疗股骨远端复杂骨折的的有效治疗方法。

Objective： To explore the indications and clinical results of less invasive stabilization system （LISS） in the treatment of complex fractures of distal femur. Methods： From Dec. 2004 to Mar. 2007, 12 patients （13 fractures） were treated with LISS, 8 males and 4 females, with an average age of 35 years （range 18-60 years）, while 1 patient sustaining distal femoral fracture and proximal tibial fracture on the ipsilateral side. The LISS plates were inserted beneath the periosteum through a small incision after closed reduction（except the intraarticular fractures）. The locking screws were inserted through stabincisions, and by mono- cortical fixation. Results 12 patients achieved bone union during the follow up 6 to 27 months. HSS score： excellent in 8 cases, good in 2 cases ,fair in 1 case ,poor in 1 case, the good--excellent rate was 83.3~. Conclusion： Treatment of the distal femur fracture with LISS might be characterized by minimally invasion, reliable fixation , rapid fracture healing and quick recovery after operation. LISS might be an effective technique in the treatment of complex fracture of the distal femur.