锁定钢板系统在股骨远端骨折的应用

目的：探讨微创内固定系统（less invasive stabilization system,LISS）治疗股骨远端骨折的方法和疗效。方法：回顾性研究2006年10月～2009年5月使用LISS钢板治疗股骨远端骨折21例的临床资料,其中,男16例,女5例,年龄22～56岁,平均39.8岁;在影像增强器监视下行闭合复位或小切口切开复位,复位满意后与肌肉下骨膜外置入LISS钢板,再次确认满意后通过导向器经皮拧入锁定螺钉。结果：本组患者均获得随访,随访时间4～22个月,平均9.4个月。术中均未输血、植骨,术后均未使用石膏外固定。伤口均一期愈合,无一例发生术后感染、骨折再移位或成角畸形。骨折临床愈合时间15.8（13～18）周。无一例发生骨折延迟愈合、不愈合或畸形愈合等现象。本组患者膝关节功能HSS评分平均88.6（71～95）分,其中优15例,良6例。各患肢功能均恢复良好。结论：微创锁定钢板系统治疗股骨远端骨折具有创伤小,对骨骼血供影响小,骨折愈合快,固定可靠,术后感染率低,并发症少等优点。

Application of locking plate system in the distal femoral fractures

Objective：To investigate the method and effect for less invasive stabilization system （LISS） treatment of distal femoral fracture.Methods：A retrospective study with 21 cases for using the LISS plate in the treatment of distal femoral fractures from October 2006 to May 2009, including 16 males and 5 females, aged from 22 to 56 years, mean age 39.8 years. To operate closed reduction or a small incision open reduction under the surveillance of the image enhancement, place LISS plate under the periosteum and outside the muscle after satisfactory reduction, then percutaneous screw lock screw through the guide when confirmed once again.Results：All patients were followed up from 4 to 22 months, an average of 9.4 months. Without blood transfusion, bone grafting, there was no need to use plaster external fixation, wound healing, and no case of postoperative infection, fracture re-displacement or angulation deformity. Healing time was 15.8 weeks （13 to 18 weeks）. No case of delayed union, nonunion or malunion occurred. Average score of knee function in this group was 88.6 by HSS （71 to 95）, which excellent was 15 cases, good was 6 cases, the limb function recovered well.Conclusion：Minimally invasive locking plate system for the treatment of distal femoral fractures with advantage of less trauma and less impact on blood supply of bone fracture healing, rigid fixation, low postoperative infection rate, and fewer complications.