何锦泉;庞贵根;马宝通;陈新;曾宪铁;

• 1:天津市天津医院

摘要(Abstract)：

[目的]分析使用微创内固定系统(less invasive stabilization system,LISS)治疗膝关节周围骨折时的并发症。[方法]自2005年7月~2007年10月,应用LISS治疗89例患者共91侧骨折,其中股骨远端骨折45侧;胫骨近端骨折46侧。[结果]术后随访时间为13~29个月,平均14.4个月。骨折平均愈合时间为16周(11~25周)。膝关节功能为优45侧,良35侧,可11侧,优良率为87.9%。10侧肢体(11%)出现钢板刺激症状,其中有2侧出现迟发的皮肤软组织全层裂开。7例(8%)骨折对位不良。2例(2%)骨折术后复位丢失。1例(1%)骨折延迟愈合。1例(1%)内固定失败。2例(2%)出现医源性神经损伤,腓浅神经与腓深神经损伤各1例。9例(10%)共14枚螺钉出现"冷焊接现象"(cold-welding)致内固定取出困难。[结论]LISS是一种治疗膝关节周围骨折有效而可靠的方法,但在临床应用中要严格掌握手术指征及操作规程。

关键词(KeyWords)： 微创内固定系统;胫骨近端;股骨远端;骨折;并发症

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 何锦泉;庞贵根;马宝通;陈新;曾宪铁;

Email:

DOI:

参考文献(References)：

• [1]Boldin C,Fankhauser F,Hofer HP,et al.Three-year results of prox-imal tibia fractures treated with the LISS[J].Clin Orthop Relat Res,2006,445:222-229.
• [2]Schutz M,Muller M,Regazzoni P,et al.Use of the less invasivestabilization system(LISS)in patients with distal femoral(AO33)fractures:a prospective multicenter study[J].Arch Orthop TraumaSurg,2005,2:102-108.
• [3]Kanabar P,Kumar V,Owen PJ.Less invasive stabilization systemplating for distal femoral fractures[J].J Orthop Surgery,2007,15:299-302.
• [4]Kregor PJ,Stannard JA,Zlowodzki M,et al.Treatment of distal fe-mur fractures using the less invasive stabilization system:surgical ex-perience and early clinical results in 103 fractures[J].J OrthopTrauma,2004,8:509-520.
• [5]薛俊民,李香民,阚永良.LISS钢板内固定治疗下肢长骨严重粉碎骨折[M].中国矫形外科杂志,2008,16:1741-1742.
• [6]Ilahi OA,Kadakia NR,Huo MH.Inter-and intraobserver variabilityof radiographic measurements of knee alignment[J].Am J KneeSurg,2001,14:238-242.
• [7]蒋协远,王大伟.骨科临床疗效评价标准[M].第1版.北京:人民卫生出版社,2005,186-187.
• [8]Stoffel K,Dieter U,Stachowiak G,et al.Biomechanical testing ofthe LCP-how can stability in locked internal fixators be controlled[J].Injury,2003,2:11-19.
• [9]Phisitkul P,Mckinley TO,Nepola JV,et al.Complications of loc-king plate fixation in complex proximal tibia injuries[J].J OrthopTrauma,2007,21:83-91.
• [10]Schandelmaier P,Partenheimer A,Koenemann B,et al.Distal fem-oral fractures and LISS stabilization[J].Injury,2001,3:55-63.
• [11]Kaab MJ,Frenk A,Schmeling A,et al.Locked internal fixator sen-sitivity of screw/plate stability to the correct insertion angle of thescrew[J].J Orthop Trauma,2004,18:483-487.
• [12]Button G,Wolinsky P,Hak D.Failure of less invasive stabilizationsystem plates in the distal femur:a report of four cases[J].J OrthopTrauma,2004,18:565-570.
• [13]De Angelis JP,Deangelis NA,Anderson R.Anatomy of the superfi-cial peroneal nerve in relation to fixation of tibia fractures with theless invasive stabilization system[J].J Orthop Trauma,2004,18:536-539.
• [14]Smith WR,Ziran BH,Anglen JO,et al.Locking plates:tips andtricks[J].J Bone Joint Surg(Am),2007,89:2298-2307.