Treatment of complex proximal tibia fractures with the less invasive skeletal stabilization system.
OBJECTIVE
Proximal tibia fractures with metaphyseal comminution present a difficult treatment challenge. The Less Invasive Skeletal Stabilization (LISS) internal fixator system has theoretical advantages (minimally invasive fixed angle construct) for the treatment of these injuries. This report presents clinical results of the LISS system for treatment of complex proximal tibia fractures and illustrates the unique properties of the system.


METHODS
Prospective clinical trial.


METHODS
Level I trauma center.


METHODS
Twenty-eight consecutive patients with comminuted proximal tibia metaphyseal fractures (41A3, 41C2, or 41C3) treated with LISS plates.


METHODS
Healing, fracture alignment, infectious and implant-related complications, and functional outcome based on the Lower Extremity Measure (LEM).


RESULTS
Average follow-up was 23 months (range 12-48). Thirty-seven of 38 patients healed their fracture after the index procedure. The other healed after implant removal without the need for further fracture repair. Postoperative fracture alignment was satisfactory in 37 of the 38 cases and was maintained in all patients at union. There were no infectious complications. The average LEM score was 88.


CONCLUSIONS
The LISS internal fixator system can be used successfully to treat complex proximal tibia fractures without the need for additional medial stabilization. Surgeons attempting to use fixed angle internal fixation plating systems should familiarize themselves with the significant technical differences between these and traditional plating systems to assure satisfactory results.
Barnes Jewish Hospital, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. ricciw@msnotes.wustl.edu
William M
WM
Ricci
Jonas R
JR
Rudzki
Joseph
J
Borrelli
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011859:Radiography; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D014193:Trauma Centers