title: Less invasive stabilization system (LISS) versus proximal femoral nail anti-rotation (PFNA) in treating proximal femoral fractures: a prospective randomized study.
abstract: OBJECTIVE
  To evaluate the outcome and efficacy of LISS (Less Invasive Stabilization System; Synthes USA, Paoli, PA) for the treatment of proximal femoral fractures to find another appropriate minimally invasive surgery for these fractures in which intramedullary nailing may be difficult.
  
  
  METHODS
  A consecutive prospective randomized clinical study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Between May 2006 and March 2008, 64 consecutive patients who had a proximal femoral fracture were randomized to be treated with fixation with either LISS or PFNA (Proximal Femoral Nail Anti-rotation; Synthes USA).
  
  
  METHODS
  LISS or PFNA fixation of proximal femoral fractures.
  
  
  METHODS
  Intraoperative time, intraoperative blood loss, length of hospitalization, hip function (Harris score), general complications, fracture complications.
  
  
  RESULTS
  Fifty-nine patients were evaluated with a mean follow-up time of 26.8 months (range, 21-36 months). No statistical differences in general complications, intraoperative blood loss, length of hospitalization, or hip function could be found between the two groups. The average operative time was longer in the LISS group (98.25 minutes) compared with the PFNA group (65.36 minutes) (P < 0.05). One PFNA case had intrapelvic penetration of the helical blade; two LISS cases had breakage of the screws.
  
  
  CONCLUSIONS
  There were no major differences in outcome or complications between the treatment groups. LISS can be used effectively in treating proximal femoral fractures, especially for complex fractures patterns in which intramedullary nailing may be difficult.
  
  
  METHODS
  Therapeutic Level II. See page 128 for a complete description of levels of evidence.
authors.affiliation: Orthopedic Department Trauma Division, Peking University Third Hospital, Beijing, China. zhou.md@126.com
authors.forename: Fang
authors.initials: F
authors.lastname: Zhou
authors.forename: Zhi Shan
authors.initials: ZS
authors.lastname: Zhang
authors.forename: Huan
authors.initials: H
authors.lastname: Yang
authors.forename: Yun
authors.initials: Y
authors.lastname: Tian
authors.forename: Hong Quan
authors.initials: HQ
authors.lastname: Ji
authors.forename: Yan
authors.initials: Y
authors.lastname: Guo
authors.forename: Yang
authors.initials: Y
authors.lastname: Lv
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing; D006621:Hip Joint / Q000503:physiopathology; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D012399:Rotation; D014102:Torsion Abnormality / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult