TY - JOUR
T1 - Treatment of proximal tibia fractures using the Less Invasive Stabilization System
T2 - Surgical experience and early clinical results in 77 fractures
AU - Cole, Peter A.
AU - Zlowodzki, Michael
AU - Kregor, Philip J.
PY - 2004/9/1
Y1 - 2004/9/1
N2 - Objective: To summarize the surgical experience and clinical results of the first 89 fractures of the proximal tibia treated with the Less Invasive Stabilization System (LISS; Synthes, Paoli, PA). Design: Retrospective analysis of prospectively enrolled patients into a database. Setting: Academic level I trauma center. Subjects/Participants: Eighty-seven consecutive patients with 89 proximal tibia fractures (AO/OTA type 41 and proximal type 42 fractures) treated by 2 surgeons. Seventy-five patients with 77 fractures were followed until union. The mean follow-up was 14 months (range: 3-35 months). There were 55 closed fractures and 22 open fractures. Intervention: Surgical reduction and fixation of fractures, followed by rehabilitation. Main Outcome Measurements: Perioperative and postoperative complications, postoperative alignment, loss of fixation, time to full weight bearing, radiographic union, and range of motion. Results: Seventy of 77 fractures healed without major complications (91%). There were 2 early losses of proximal fixation, 2 nonunions, 2 deep delayed infections, and 1 deep peroneal nerve palsy. Other complications included a superficial wound infection and 3 seromas. Postoperative malalignment occurred in 7 patients with 6° to 10° of angular deformity (6 flexion/extension and 1 varus/valgus malalignments), and an eighth patient had a 15° flexion deformity. In 4 patients, the hardware was removed at an average of 13 months because of irritation (5%). The mean time for allowance of full weight bearing was 12.6 weeks (range: 6-21 weeks), and the mean range of final knee motion was 1° to 122°. Conclusions: The LISS provides stable fixation (97%), a high rate of union (97%), and a low (4%) rate of infection for proximal tibia] fractures. The technique requires the successful use of new and unfamiliar surgical principles to effect an accurate reduction and acceptable rate of malalignment.
AB - Objective: To summarize the surgical experience and clinical results of the first 89 fractures of the proximal tibia treated with the Less Invasive Stabilization System (LISS; Synthes, Paoli, PA). Design: Retrospective analysis of prospectively enrolled patients into a database. Setting: Academic level I trauma center. Subjects/Participants: Eighty-seven consecutive patients with 89 proximal tibia fractures (AO/OTA type 41 and proximal type 42 fractures) treated by 2 surgeons. Seventy-five patients with 77 fractures were followed until union. The mean follow-up was 14 months (range: 3-35 months). There were 55 closed fractures and 22 open fractures. Intervention: Surgical reduction and fixation of fractures, followed by rehabilitation. Main Outcome Measurements: Perioperative and postoperative complications, postoperative alignment, loss of fixation, time to full weight bearing, radiographic union, and range of motion. Results: Seventy of 77 fractures healed without major complications (91%). There were 2 early losses of proximal fixation, 2 nonunions, 2 deep delayed infections, and 1 deep peroneal nerve palsy. Other complications included a superficial wound infection and 3 seromas. Postoperative malalignment occurred in 7 patients with 6° to 10° of angular deformity (6 flexion/extension and 1 varus/valgus malalignments), and an eighth patient had a 15° flexion deformity. In 4 patients, the hardware was removed at an average of 13 months because of irritation (5%). The mean time for allowance of full weight bearing was 12.6 weeks (range: 6-21 weeks), and the mean range of final knee motion was 1° to 122°. Conclusions: The LISS provides stable fixation (97%), a high rate of union (97%), and a low (4%) rate of infection for proximal tibia] fractures. The technique requires the successful use of new and unfamiliar surgical principles to effect an accurate reduction and acceptable rate of malalignment.
KW - Less Invasive Stabilization System
KW - Less invasive
KW - Locked plate
KW - Minimally invasive
KW - Submuscular plating
KW - Tibia fracture
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U2 - 10.1097/00005131-200409000-00008
DO - 10.1097/00005131-200409000-00008
M3 - Article
C2 - 15475848
AN - SCOPUS:4644371690
SN - 0890-5339
VL - 18
SP - 528
EP - 535
JO - Journal of orthopaedic trauma
JF - Journal of orthopaedic trauma
IS - 8
ER -