The less invasive stabilization system in treatment of complex proximal femoral fractures / 中华创伤骨科杂志

ABSTRACT

Objective To discuss the feasibility,indications,surgical techniques,and outcome con- cerning the application of less invasive stabilization system (LISS) for complex proximal femoral fractures.Methods We treated 12 complex proximal femoral fractures using femoral LISS reversely from June 2005 to May 2006. They were five complex intertrochanteric fractures and seven subtrochanteric ones.By AO classification,two were type 31-A2.2,two type 31-A2.3,one type 31-A3.3,one type 32-A3.1,three type 32-B1.1,one type 32-B2.1, and two type 32-B3.I.The patients were treated with closed or indirect reduction and fixation with percutaneous LISS plate reversely.Results There were no major postoperative complications in this study.The mean operation time was 65 minutes (range,50 to 90 minutes),the mean intra-operative blood loss was 142 milliliters (range,50 to 400 milliliters),and the mean postoperative hospital stay was 9.3 days (range,6 to 15 days).All patients had a clinical follow-up;the mean follow-up time was 7.2 months (range,3 to 14 months).Ten cases healed clinically three months postoperatively,one periprosthetic fracture healed four months and one pathological fracture healed six months after operation.At the final radiographic follow-up,no collapse,varus deformity,cutting-out,hardware failure,or avascular necrosis was found.Conclusions Femoral LISS used reversely can provide secure fixation for proximal femoral fractures biomechanically and anatomically.It is also easy and safe.It is particularly suitable for old patients with intertrochanteric fractures complicated with disorders of internal organs and severe osteoporosis or patients with complex proximal femoral fractures.It is important to be skillful in indirect reduction and positioning of guide wire into hole A,and to avoid immediate weight-bearing postoperatively.