Surgical treatment of fractures of the distal femur using the LISS system

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Abstract

Osteosynthesis with LISS system (less invasive stabilization system) is a new technology and this conception of stabilization of long bone fragments is a new step in the development of AO philosophy. Indications to application of this system are distal metaepiphysis and diaphysis femur fractures, supra- and transcondylar fractures in polytrauma, fractures in osteoporosis as well as fractures after total knee replacement. During the last 3 years 35 patients were operated on by that technique. The follow-up period ranged from 6 months to 3 years. Assessment of outcomes was performed using data of clinical examination and evaluation of radiograms with modified Neer-Grantham-Shelton scale. In patients who were operated on 1 year ago the total score varied from 70 to 80 (maximum — 100). Advantages of this technology as compared to the traditional methods of osteosynthesis are the following: limited operative trauma, less blood loss, shortening of surgery duration, preservation of tissue physiology as well as absence of the necessity to use cement and bone auto- and allografts. Disadvantages include the difficulty for reposition prior to fixation and impossibility of correction in postoperative period as well as early weight-bearing load.

About the authors

D. Cherkes-Zade

University Clinic of Traumatology and Orthopedics

Email: info@eco-vector.com
Italy, Udine

M. Monesi

Department of Traumatology and Orthopedics, Civil Hospital

Email: info@eco-vector.com
Italy, Udine

A. Causero

University Clinic of Traumatology and Orthopedics

Email: info@eco-vector.com
Italy, Udine

M. Marcolini

Department of Traumatology and Orthopedics, Civil Hospital

Author for correspondence.
Email: info@eco-vector.com
Italy, Udine

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. LISS-DF system.

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3. Fig. 2. Deviation of the plate from the longitudinal axis of the limb, caused by the emphasis of the proximal screws on the distal end of the intramedullary nail.

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4. Fig 3. Poor reposition of fragments and, as a result, incorrect position of the implant.

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5. Fig. 4. Patient X. 79 years old. Fracture 33A. a — radiographs before surgery, b — after surgery; c — volume of movements 1 year after the operation.

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6. Fig. 5. Patient Y. 72 years old. "Paraprosthetic" fracture as a result of an accidental fall. a — radiographs before surgery, b — after surgery, c — 6 months after surgery: callus is determined; d — control 1.5 years after the operation.

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