Fixation of distal femoral fractures with the Less Invasive Stabilization System: a minimally invasive treatment with locked fixed-angle screws

• Published in: The journal of trauma Vol. 65; no. 6; p. 1425
• Main Authors: Kolb, Werner, Guhlmann, Hanno, Windisch, Christoph, Marx, Frank, Kolb, Klaus, Koller, Heiko
• Format: Journal Article
• Language: English
• Published: United States 01.12.2008
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bone Malalignment - diagnostic imaging; Bone Malalignment - surgery; Bone Plates; Bone Screws; Bone Transplantation; Early Ambulation; Female; Femoral Fractures - diagnostic imaging; Femoral Fractures - surgery; Fracture Fixation, Internal - instrumentation; Fracture Healing - physiology; Humans; Knee Injuries - diagnostic imaging; Knee Injuries - surgery; Male; Middle Aged; Minimally Invasive Surgical Procedures - instrumentation; Postoperative Complications - diagnostic imaging; Postoperative Complications - physiopathology; Postoperative Complications - surgery; Radiography; Range of Motion, Articular - physiology; Reoperation; Retrospective Studies; Young Adult
• ISSN: 1529-8809
• DOI: 10.1097/TA.0b013e318166d24a

The Less Invasive Stabilization System (LISS) is an internal fixator, which combines closed reduction of the diaphysis or metaphysis of distal femur fractures with locked unicortical screw fixation. In a retrospective consecutive study, 50 patients with Association for the Study of the Problems of Internal Fixation/Orthopaedic Trauma Association (AO/OTA) type 33-A1 to 33-C3 fractures were treated with the LISS between January 1999 and December 2003. Final results were assessed using the functional score of Neer after a median follow-up of 29 months (15-48 months). Fifteen male and 16 female patients were followed up. The mean age was 49 years (17-90 years). Deep wound infection was seen in one patient (3%) and malpositioning with cutting-out of the proximal screws was in two patients (6%). All other fractures healed uneventfully without bone graft requirements after a mean of 12 weeks (7-20 weeks). A revised osteosynthesis was performed for correction of a valgus deformity of 20 degrees after 4 months. There was no difference in leg length exceeding 2 cm. One patient had a valgus deformity of 10 degrees combined with a rotational deformity of 10 degrees. Range of motion of the knee joint was >120 degrees in 15 patients (48%); 12 (39%) had a range of motion between 90 degrees and 120 degrees and 4 (13%) between 70 degrees and 90 degrees. The function according to the Neer score was excellent in 15 (48%), good in 10 patients (32%), and fair in 6 patients (20%). The mean Neer score was 80 (60-100). The LISS promotes early mobilization and rapid rates of bony and clinical healing without bone grafting with low rates of infection.