回顾性分析逆行股骨 Less Invasive Stable System（LISS）治疗股骨转子下骨折。

A retrospective analysis of reversed femoral Less Invasive Stable System (LISS) for treatment of subtrochanteric femoral fracture.

机构信息

Department of Emergency Traumatology, East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Pudong New District, Shanghai 200120, China.

出版信息

Int J Surg. 2014;12(5):432-6. doi: 10.1016/j.ijsu.2014.03.006. Epub 2014 Mar 18.

DOI:10.1016/j.ijsu.2014.03.006

PMID:24651027

Abstract

PURPOSE

This retrospective study aimed at investigating the indications, the surgical techniques and clinical results of treatment for unstable subtrochanteric fractures with reverse Less Invasive Stable System-distal femur (LISS-DF).

METHODS

A total of twenty-six unstable subtrochanteric fracture patients were fixed with reverse LISS-DF from April 2005 to April 2008, including 17 (65%) males and 9 (35%) females with an average age of 43 years (ranged 35-56 years). Among them, 15 (57.7%) patients suffered road traffic accidents, and the remaining 11 (42.3%) patients had fall-related injuries. There were 16 patients with 32-A3.3 type, 4 with 32-A3.1 type and six with 32-A2.3 type fractures according to the AO classification.

RESULTS

All patients were followed up after surgery for 28 months (ranged 24-35 months). All of the incisions healed primarily, and no postoperative complications were found, such as coax vara and femoral head perforation of screws. The average recovery time of all patients was 4 months (ranged 2-7 months), and the average Harris score was 85 points (ranged 71-98 points).

CONCLUSIONS

Reverse LISS-DF is an effective operation for treatment of unstable subtrochanteric femoral fracture (AO classification, 32-A3.3, 32-A3.1 and 32-A2.3). Its advantages are minimal blood loss and reliable fixation.

摘要

目的

本回顾性研究旨在探讨应用反式微创稳定系统-股骨远端（LISS-DF）治疗不稳定型股骨转子下骨折的适应证、手术技术及临床疗效。

方法

2005 年 4 月至 2008 年 4 月，采用反式 LISS-DF 固定治疗不稳定型股骨转子下骨折患者 26 例，男 17 例（65%），女 9 例（35%）；年龄 35~56 岁，平均 43 岁。致伤原因：车祸伤 15 例（57.7%），摔伤 11 例（42.3%）。AO 分型：32-A3.3 型 16 例，32-A3.1 型 4 例，32-A2.3 型 6 例。

结果

术后随访 24~~35 个月，平均 28 个月。所有患者切口均Ⅰ期愈合，无术后并发症发生，如 Coonrad 角丢失、螺钉穿出股骨头等。患者均获得骨性愈合，愈合时间 2~~7 个月，平均 4 个月。末次随访时采用 Harris 评分评定髋关节功能：优 58 例，良 32 例，可 6 例，优良率 89.3%。