倒置LISS治疗股骨近端粉碎性骨折的疗效分析

目的：探讨倒置股骨远端锁定接骨板（LISS）治疗股骨近端粉碎性骨折的临床疗效。方法：回顾性分析2010年8月-2014年3月应用倒置LISS治疗44例股骨近端粉碎性骨折的患者资料,均为闭合性损伤。AO分型均为31-A3.3型。采用倒置LISS有限切开内固定治疗。记录临床和影像学结果,根据Harris髋关节功能评分标准,评价术后髋关节功能。结果：41例获得随访,随访时间6-28个月,平均13.8个月。1例死于内科疾患加重,2例出现髋内翻畸形,所有病例骨折均愈合,愈合时间为4-8个月,平均6.1个月。末次随访时Harris髋关节评分为86-97分,平均93分,其中优30例,良8例,可3例,优良率为92.7%（38/41）。结论：应用倒置LISS治疗股骨近端粉碎性骨折能够更好的重建外侧壁,避免外侧壁的医源性损伤,具有固定可靠、疗效肯定的优点,是治疗此类骨折的有效方法。

The Clinical Effect of LISS Inversion for the Proximal Femoral Comminuted Fractures

Objective：To evaluate the clinical effect of the proximal femoral comminuted fractures using inversed less invasive stabilization system（LISS）. Method：From August 2010 to March 2014,44 patients with proximal femoral comminuted fractures were treated with LISS inversion.All of the cases were closed injury. Accorded to the AO/OTA classification, all of the cases were in 31-A3.3.LISS inversion and mini-incision was applied to internal fixation treatment.The Clinical and radiographic outcomes were recorded. The postoperative hip function was evaluated using Harris score.Result：41 cases were followed up for 6 to 28 months,mean of 13.8 months.One case died of medical disorder and two case was noted of coxa vara deformity.Solid bony union was achieved in all cases. The time of fracture healing was 4-8 months,mean of 6.1 months.At final followed up,30 cases were classified as excellent, 8 as good, and 3 as fair. The Harris hip score was 86-97 points,mean of 93 points.The overall rate of excellent and good result were 92.7%.Conclusion：LISS inversion is a reliable and effective treatment for the proximal femoral comminuted fractures.