de la Caffinière J Y, Pelisse F, de la Caffinière M
Department of Orthopaedics and Traumatology, Saint-Denis Hospital, Ile-de-France, France.
J Bone Joint Surg Br. 1994 Sep;76(5):778-88.
We report the use of a new method of locked intramedullary flexible osteosynthesis (LIFO) in the treatment of 118 unstable fractures of the femur and tibia. The implant utilises a set of flexible pins with a separate locking device for their proximal ends. The LIFO system proved capable of stabilising unstable fractures, and most of the complications occurred during the early testing. At follow-up, 19 of 21 femoral fractures had healed; one become infected and one showed defective callus. Of the 78 tibial shaft fractures, five failed to consolidate and five had inadequate callus. Reaming of the tibial medullary canal was never necessary. Of 28 open fractures only one became infected. The system was most difficult to use in comminuted distal fractures of the tibia, with five failures of healing in 19 cases; these cases require considerable technical proficiency. The flexibility of the system appears to promote earlier consolidation of open fractures, and normal consolidation times for fractures with interfragmentary gaps of up to 10 to 12 mm. A comparative study of callus density in tibial fractures showed a mean improvement of 50 days in cases treated by the LIFO system compared with similar cases treated by rigid nailing.
我们报告了一种新型锁定髓内弹性接骨术（LIFO）在治疗118例股骨和胫骨不稳定骨折中的应用。该植入物采用一组弹性针，并在其近端配有一个单独的锁定装置。LIFO系统被证明能够稳定不稳定骨折，且大多数并发症发生在早期试验期间。随访时，21例股骨骨折中有19例愈合；1例发生感染，1例骨痂形成不良。在78例胫骨干骨折中，5例未愈合，5例骨痂不足。从未需要对胫骨髓腔进行扩髓。28例开放性骨折中仅1例发生感染。该系统在胫骨远端粉碎性骨折中最难使用，19例中有5例愈合失败；这些病例需要相当高的技术水平。该系统的弹性似乎促进了开放性骨折的早期愈合，以及骨折块间间隙达10至12毫米的骨折的正常愈合时间。一项关于胫骨干骨折骨痂密度的对比研究显示，与采用刚性髓内钉治疗的类似病例相比，采用LIFO系统治疗的病例平均愈合时间提前了50天。
