Kregor Philip J, Stannard James A, Zlowodzki Michael, Cole Peter A
Division of Orthopedic Trauma, Department of Orthopedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
J Orthop Trauma. 2004 Sep;18(8):509-20. doi: 10.1097/00005131-200409000-00006.
To summarize the complications and early clinical results of 123 distal femur fractures treated with the Less Invasive Stabilization System (LISS; Synthes, Paoli, PA).
Retrospective analysis of prospectively enrolled patients.
Two academic level I trauma centers.
One hundred nineteen consecutive patients with 123 distal femur fractures (OTA type 33 and distal type 32 fractures) treated by 3 surgeons. One hundred three fractures (68 closed fractures and 35 open fractures) in 99 patients were followed up at least until union (mean follow-up = 14 months, range: 3-50 months).
Surgical reduction and fixation of distal femur fractures.
Perioperative complications, radiographic union, infection rate, loss of fixation, alignment, and range of motion.
Ninety-six (93%) of 103 fractures healed without bone grafting. All fractures eventually healed with secondary procedures, including bone grafting (1 of 68 closed fractures and 6 of 35 open fractures). There were 5 losses of proximal fixation, 2 nonunions, and 3 acute infections. No cases of varus collapse or screw loosening in the distal femoral fragment were observed. Malreductions of the femoral fracture were seen in 6 fractures (6%). The mean range of knee motion was 1 degrees to 109 degrees .
Treatment of distal femur fractures with the LISS is associated with high union rates without autogenous bone grafting (93%), a low incidence of infection (3%), and maintenance of distal femoral fixation (100%). No loss of fixation in the distal femoral condyles was observed despite the treatment of 30 patients older than 65 years. The LISS is an acceptable surgical option for treatment of distal femoral fractures.
总结采用微创稳定系统（LISS；辛迪思公司，波利，宾夕法尼亚州）治疗的123例股骨远端骨折的并发症及早期临床结果。
对前瞻性纳入患者的回顾性分析。
两家一级学术创伤中心。
119例连续患者共123处股骨远端骨折（OTA 33型和32型远端骨折），由3名外科医生治疗。99例患者的103处骨折（68例闭合性骨折和35例开放性骨折）至少随访至骨折愈合（平均随访时间 = 14个月，范围：3 - 50个月）。
股骨远端骨折的手术复位与固定。
围手术期并发症、影像学骨折愈合、感染率、内固定失败、对线情况及活动范围。
103处骨折中有96处（93%）未行植骨而愈合。所有骨折最终均经二次手术愈合，包括植骨（68例闭合性骨折中的1例和35例开放性骨折中的6例）。近端内固定失败5例，骨不连2例，急性感染3例。未观察到股骨远端骨块出现内翻塌陷或螺钉松动的病例。6处骨折（6%）出现股骨骨折复位不良。膝关节平均活动范围为1°至109°。
使用LISS治疗股骨远端骨折的愈合率高（93%），无需自体骨移植，感染发生率低（3%），且股骨远端内固定维持良好（100%）。尽管治疗了30例年龄大于65岁的患者，但未观察到股骨远端髁部内固定失败。LISS是治疗股骨远端骨折的一种可接受的手术选择。
