title: Reverse LISS plating for intertrochanteric hip fractures in elderly patients.
abstract: BACKGROUND
  Fractures of the intertrochanteric hip are common and the treatment of unstable fractures generally requires an operative approach. In elderly patients, osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results. We have attempted to apply the Less Invasive Stabilization System (LISS) in reverse position for the repair of intertrochanteric hip fractures in elderly patients with osteoporotic bones. A retrospective review is presented of the cases of 28 elderly patients with stable and unstable fractures of the intertrochanteric hip treated using the reverse LISS.
  
  
  METHODS
  We treated 28 elderly patients with a mean age of 82.3 years. According to the Evens classification, there were 2 Type I fractures, 2 Type II fractures, 3 Type III fractures, 13 Type IV fractures, 6 Type V fractures and 2 Type R fractures. All fractures were treated using the reverse LISS. Radiographic and clinical evidence of functional outcome and complications were evaluated.
  
  
  RESULTS
  Mean perioperative blood loss was 92.4 milliliters (range 35 to 245 milliliters), and the mean postoperative hospital stay was 8.7 days (range 3 to 14 days).Complications included one minor wound hematoma. Radiographically, no collapses, screw cutouts, or head penetrations were seen. All surviving patients (28 of 28; 100 percent) had uneventful fracture healing with union achieved by six months in all patients.
  
  
  CONCLUSIONS
  Use of the Reverse LISS plating for intertrochanteric hip fractures resulted in event-free fracture healing.
authors.affiliation: Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, PR China. zhangchqin@yahoo.cn
authors.forename: C Q
authors.initials: CQ
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.forename: D X
authors.initials: DX
authors.lastname: Jin
authors.forename: C
authors.initials: C
authors.lastname: Yao
authors.forename: S B
authors.initials: SB
authors.lastname: Chen
authors.forename: B F
authors.initials: BF
authors.lastname: Zeng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000592:standards*; D001861:Bone Regeneration / Q000502:physiology; D005260:Female; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators / Q000592:standards*; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods; D010024:Osteoporosis / Q000150:complications; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome