Successful results of minimally invasive surgery for comminuted supracondylar femoral fractures with LISS: comparative study of multiply injured and isolated femoral fractures.

摘要

BACKGROUND: The aim of this prospective study was to compare the outcomes of distal femoral fractures treated by the Less Invasive Stabilization System (LISS) in multiply injured and isolated fracture cases. METHODS: This study comprised 26 patients (16 men, 10 women), who had 27 distal femoral fractures. Patients were divided into two groups; multiple injuries (group I) or isolated distal femoral fracture (group II). The average Injury Severity Score of group I was 26.7. Operations were performed according to biological fixation principles in a submuscular manner. No bone grafting was performed to enhance the healing. The cases were evaluated based on the criteria of Schatzker-Lambert and the modified Hospital for Special Surgery (HSS) scoring system. RESULTS: The mean follow-up period was 25.8 months. Union was achieved in all cases. Two patients in group I required debridement procedures due to deep infection. One of them healed completely but the other did not. The average range of knee motion of groups I and II at the last control were 112.8 degrees and 121.8 degrees , respectively. The mean modified HSS scores were 73.9 and 79.9, respectively. There was no significant difference in the HSS scores or the range of knee motion. The time to full weight bearing was longer in group I owing to the concomitant injuries. CONCLUSIONS: We concluded that LISS is a useful method for comminuted supracondylar fractures with multiple trauma patients as the results showed no significant differences when compared with those of patients with isolated femoral fractures.