Treatment of Proximal Tibia Fractures Using the Less Invasive Stabilization System
- 1 September 2004
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Orthopaedic Trauma
- Vol. 18 (8), 528-535
- https://doi.org/10.1097/00005131-200409000-00008
Abstract
To summarize the surgical experience and clinical results of the first 89 fractures of the proximal tibia treated with the Less Invasive Stabilization System (LISS; Synthes, Paoli, PA). Retrospective analysis of prospectively enrolled patients into a database. Academic level I trauma center. Eighty-seven consecutive patients with 89 proximal tibia fractures (AO/OTA type 41 and proximal type 42 fractures) treated by 2 surgeons. Seventy-five patients with 77 fractures were followed until union. The mean follow-up was 14 months (range: 3-35 months). There were 55 closed fractures and 22 open fractures. Surgical reduction and fixation of fractures, followed by rehabilitation. Perioperative and postoperative complications, postoperative alignment, loss of fixation, time to full weight bearing, radiographic union, and range of motion. Seventy of 77 fractures healed without major complications (91%). There were 2 early losses of proximal fixation, 2 nonunions, 2 deep delayed infections, and 1 deep peroneal nerve palsy. Other complications included a superficial wound infection and 3 seromas. Postoperative malalignment occurred in 7 patients with 6 degrees to 10 degrees of angular deformity (6 flexion/extension and 1 varus/valgus malalignments), and an eighth patient had a 15 degrees flexion deformity. In 4 patients, the hardware was removed at an average of 13 months because of irritation (5%). The mean time for allowance of full weight bearing was 12.6 weeks (range: 6-21 weeks), and the mean range of final knee motion was 1 degrees to 122 degrees . The LISS provides stable fixation (97%), a high rate of union (97%), and a low (4%) rate of infection for proximal tibial fractures. The technique requires the successful use of new and unfamiliar surgical principles to effect an accurate reduction and acceptable rate of malalignment.Keywords
This publication has 10 references indexed in Scilit:
- Biomechanical Evaluation of the Less Invasive Stabilization System, Angled Blade Plate, and Retrograde Intramedullary Nail for the Internal Fixation of Distal Femur FracturesJournal of Orthopaedic Trauma, 2004
- Operative Treatment of Extra-Articular Proximal Tibial FracturesJournal of Orthopaedic Trauma, 2003
- Less invasive stabilization system (LISS) for fractures of the proximal tibia: Indications, Surgical Technique and Preliminary Results of the UMC Clinical TrialInjury, 2003
- LISS PLT: design, mechanical and biomechanical characteristics.Injury, 2003
- Stabilization of proximal tibial fractures with the LIS-System: Early clinical experience in BerlinInjury, 2003
- HIGH-ENERGY FRACTURES OF THE TIBIAL PLATEAUThe Journal of Bone and Joint Surgery-American Volume, 2002
- Treatment of Complex (Schatzker Type VI) Fractures of the Tibial Plateau With Circular Wire External Fixation: Retrospective Case ReviewJournal of Orthopaedic Trauma, 2000
- Hybrid External Fixation of Comminuted Tibial Plateau FracturesClinical Orthopaedics and Related Research, 1996
- External fixation and limited internal fixation for complex fractures of the tibial plateau.The Journal of Bone & Joint Surgery, 1995
- Tibial Plateau FracturesJournal of Orthopaedic Trauma, 1987