微创liss钢板治疗股骨远端与胫骨近端粉碎性骨折

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1、新疆医科大掌医掣蝎炙士掌位论文TreatmentofdistalfemoralorproximaltibiafracturesbyInternalFixationwiththelessinvasivestabilizationsystem(LISS)Postgraduate：JiGuoqingSupervisor：CaoLiTheorthopaedicsdepartmentofthefirstaffiliatedhospitalofXinjiangMedicalUniversityAbstractobjectiveToexplorethe

2、clinicalresultoffixationonthedistalfemurand／orproximaltibiafracturewithLISS(LessInvasiveStabilizationSystem)，andtoanalyzetherelatedfactorsduringtheoperation．MethodsFromMar．2004toJan．2008．11patients(1lfractures)weretreatedwithLISS．Therew．ere9malesand2females，withagefrom32t

3、o49years(mean,41years)，including9distalfemoralfracturesand2proximaltibialfractures．硼1eLISSplateswereinsertedbeneaththeperiosteumthroughasmallincisionafterclosedreduction(excepttheintraarticularfractures)．Thelockingscrewswereinsertedthroughstabincisions，andbymonocorticalfi

4、xation．Nopatientunderwentthebonegraft．ResultsAlmostallthepatientsachievedboneunionduringthefollowupfrom3to23months(mean，10months)．3patientshadtheirimplantsremoved．ThefunctionofthekneewasevaluatedaccordingtOHSSscoresystembasedonboththesubjectivefeelingandobjectivePE，andthe

5、rewere5excellentand5good，andlpoor,thegood-excellentrateWas90．9％．Secondaryreductionlossoccurredinonepatient．butboneunionandthefunctionofthekneewerenotcompromised．TherewasnoinfectioniIlallofthepatients．ConclusionTheuniquedesignedLISShastheadvantagesofprotectingthebloodsuppl

6、yofbonefragmentsandtheperiosteum，optimizingboneunionandfunctionrecovery．LISSprovidesanalternativefortreatmentofdistalfemoralorproximaltibialfractures．However,asanewdesignedsystem,notonlyconceptionbuttheprocedureaswellshouldbedemandedstrictly．KeywordsFemoralfractures；Tibia

7、lfractures；Fracturefixation,internal：Treatmentoutcome2—10—J-日}I舌股骨远端及胫骨近端粉碎性骨折是膝关节周围的一种严重损伤，由于骨折位于干骺端，邻近关节面，且为粉碎性，临床治疗较为棘手，是创伤骨科的一大难点。保守治疗常造成对线不良、骨折不愈合及膝关节僵直Ⅲ，仅适于儿章移位不明显或经简单手法即可复位的稳定骨折嘲。为了降低其后遗症的发生率，常需要进行切开复位，手术治疗。而股骨远端粉碎性骨折由于其解剖限制了髓内固定系统的应用，因此不能达到有效固定。虽然外固定技术治疗此类骨折有时也能取得

8、良好的效果，但是长期固定会合并钉道感染、固定钉松动，引起骨折不愈合从而影响生活及功能圆。对于胫骨近端骨折往往由于受伤时能量较高，软组织容易出现坏死、感染等并发症∞1，同时胫骨上端胫前区软组织少