Use of the Less Invasive Stabilization System (LISS) in patients with distal femoral (AO33) fractures: a prospective multicenter study

Abstract

The LISS showed good overall results in the treatment of these difficult fractures. It is a good alternative to conventional extramedullary and intramedullary stabilizing techniques, especially in more complex fracture situations.

2010 Mid-America Orthopaedic Association Physician in Training Award: Healing Complications Are Common After Locked Plating for Distal Femur Fractures

“…If we speculated all these 16 fractures healed, the study nonunion rate would decrease to 14 of 86 (16%). Although some authors have reported a 100% union rate in small series [6,16,31,34,35], most larger series have found a substantial rate of healing difficulties [6,20,[27][28][29]32]. When nonunion, delayed union, the need for secondary surgery, and hardware failure are considered, the rate of healing difficulties reported in the literature is comparable to the rate in our study (Table 6) [6, 7, 11, 14-16, 20, 27-29, 31, 32, 34, 35].…”

“…Reported clinical nonunion rates after treatment of distal femur fractures with locking plates vary between 0% and 10% [6,7,11,16,20,27,29]. Difficulties with fracture healing in the distal femur may present clinically as delayed union, hardware failure, loss of alignment, or an established nonunion.…”

A study of long term functional outcome of surgical management of distal femur fractures in adults using locking compression plate in Indian rural set up

“…In Rajnish R menon et al [9] study 2% delayed union was reported Complication rate is 15% (10% non-union and 5% delayed union) and 1 case (2.5%) of implant failure occurred at the end of 8 months. Schutz et al [10] reported 4.5% implant failure rate. In our study it was a case of comminuted supracondylar fracture Muller type C3, which went for a complication of screw breakage and implant failure.…”

Surgical management of distal end femoral fractures in adults with locking compression plate

“…Conservative management may result in serious complications such as knee stiffness, inadequate alignment, delayed union or nonunion, prolonged hospitalization and related morbidity [3] . To achieve functional rehabilitation of the limb, surgical treatment should be performed to achieve complete anatomic restoration of the joint surface, adequate anatomical alignment, stable and rigid fixation without external immobilization to allow early mobilization [4,6,7] . Various types of internal fixation have been developed for this purpose.…”

“…However, with double plating there is often extensive soft tissue stripping on both sides of the femur, resulting in reduced blood supply and potential non-union and failure of the implants [2, 5, 6,] Most commonly used implant for the fixation of distal femur fractures are Fixed angle devices, usually in the form of Dynamic Condylar Screw (DCS) system, which is a supracondylar plate combined with a lag screw. This two piece device is more forgiving and allows correction in the sagittal plane after the lag screw is inserted [7,8] The LCP is a single beam construct where the strength of its fixation is equal to the sum of all screw-bone interfaces rather than a single screw's axial stiffness or pullout resistance as seen in unlocked plates. Its unique biomechanical function is based on splinting rather than compression resulting in flexible stabilization, avoidance of stress shielding and induction of callus formation.…”