Department of Orthopaedics, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, People's Republic of China.
Int Orthop. 2012 Aug;36(8):1687-93. doi: 10.1007/s00264-012-1547-0. Epub 2012 May 3.
The less invasive stabilization system (LISS) can effectively treat tibial fractures. However, the LISS is technically demanding, has a long learning curve, and presents a heavy economic burden to patients. The U-grooved locking compression plate (U-LCP), characterized by a U-groove at each end, is designed to treat tibial fractures. This paper reports the outcomes of tibial fractures treated using the U-LCP compared with the LISS.
Seventy-eight patients with unilateral tibial fractures treated with either the U-LCP (group I) or LISS (group II) were enrolled. In group I, a U-LCP was inserted subcutaneously with two Kirschner wires embedded into the U-grooves to temporarily secure the plate. A second identical plate was placed over the first to guide screw insertion. In group II, the LISS was used to fix the tibial fractures. Patient age, sex, fracture type, severity of soft tissue injury, operative time, fluoroscopic time, complications, and functional recovery of affected limbs were recorded.
The two groups were comparable in age, sex, fracture type, and severity of soft tissue injury (p > 0.05). The average operation and fluoroscopic times in group I were significantly less than those in group II (p < 0.05). At follow-up, all fractures healed. There were no significant differences between both groups in time to bony union, wound complication rate, or functional recovery of injured limbs (p > 0.05).
The U-LCP can yield good outcomes in the treatment of proximal tibial fractures, with less radiation exposure, a shorter operation time, and a sustainable price compared with the LISS.
微创稳定系统(LISS)可有效治疗胫骨骨折。然而,LISS 技术要求高,学习曲线长,且对患者经济负担重。U 形槽锁定加压钢板(U-LCP)的设计特点是在两端各有一个 U 形槽,用于治疗胫骨骨折。本文报告了使用 U-LCP 与 LISS 治疗胫骨骨折的结果。
纳入 78 例单侧胫骨骨折患者,分别采用 U-LCP(I 组)或 LISS(II 组)治疗。I 组中,U-LCP 经皮插入,两根克氏针嵌入 U 形槽以临时固定钢板。再将第二个相同的钢板放在第一个上面以引导螺钉插入。II 组中,采用 LISS 固定胫骨骨折。记录患者年龄、性别、骨折类型、软组织损伤严重程度、手术时间、透视时间、并发症以及患侧肢体功能恢复情况。
两组在年龄、性别、骨折类型和软组织损伤严重程度方面无统计学差异(p>0.05)。I 组的平均手术和透视时间明显短于 II 组(p<0.05)。随访时,所有骨折均愈合。两组间在骨折愈合时间、伤口并发症发生率和受伤肢体功能恢复方面无统计学差异(p>0.05)。
U-LCP 治疗胫骨近端骨折可获得良好的结果,与 LISS 相比,其放射暴露更少、手术时间更短、价格更可持续。