Minimally Invasive Liss Plate Treatment Of Proximal Tibial Metaphyseal Fractures,

Objective To investigate the method using LISS (less invasive stabilization system) as internal fixed devices treatment for proximal tibial fractures, comparing with the methods and the short-term clinical result of'using an ordinary blade plate.Methods From December 2004 to December 2006, we collected the patients of proximal tibial fractures in total 56 cases, including of 24 patients of Liss blade plates (the SWISS AO/ASIF equipment, 32 patients of the ordinary steel plates. After operation, take normal precautions against infection and medication treatment such as stanching bleeding, boosting fracture healing and generally no need outside fixes; The recovering training program should be proceeded individually based on each specific and personality.Results All the patients achieved bone union during the following-up from 4 months to 13 months. Except 1 case implant pull-out in the ordinary steel plates, there was neither,bone infection nor implant pull-out and breakage. All the patients had some swelling after operation, and had gone down in three days.Compared the treatments between Micro LISS blade plate and ordinary steel fixed plate to proximal tibialfractures, Micro LISS blade plate has a greatly improvement to reduce the bleeding, speed the clinical recovering time of cutting area and bone union and short the full-loading recovering time. (P＜0.05)Trough statistics and testing between two fixed devices, Lissblade plate fixed sets is excellent in 15 cases, good in 5 cases, acceptable in 3 cases, and poor in 1 case. so the good-excellent rate in 83.3%; ordinary steel plates is excellent in 18 cases, good in 8 cases, acceptable in 5 cases, and poor in 1cases. sothe good-excellent rate in 81.3%. after operation about the paint status of the injured-knee, there is no obvious differences resultes (P＞0.05).comparing about the knee activities scope, Liss blade plate fixed sets is excellent in 16 cases, good in 5 cases, acceptable in 2 cases, and poor in 1 case. so the good-excellent rate in 87.5%; ordinary steel plates is excellent in 16 cases, good in 9 cases, acceptable in 5 cases, and poor in 2 cases, so the good-excellent rate in 78.1%. Thus, after statistics, which reflects greatly obvious difference on the knee recovering(P＜0.05). LISS fixed blade plate is much better to help recover the knee activities.Comparing about the clinical efficacy according to Johner-Wruhs method, LISS blade plate is excellent in 17 cases, good in 4 cases ,acceptable in 2 cases , and poor in 1 case ,the good-excellent rate in 87.5%; ordinary blade plate is is excellent in 16.cases, good in 10 cases, acceptable in 4 casess, and poor in 2 cases, the good-excellent rate in 81.2%. After statistics and investigate, which reflects great obvious difference, and LISS blade plate is better in operated short-term clinical efficacy. (P＜0.05)Comparing the two groups from the aspect of economic, micro LISS blade plate has a shortcoming that the average cost is more expensive and the operation time is much longer due to more frequent X-ray, which will increase the patients' expense burden (P＜0.01)Conclusion Compared the treatments between Micro LISS blade plate and ordinary steel fixed plate, to proximal tibial fractures, using LISS blade plate is advantaged in making the operation simply, better for recovering, and shortening the clinical recovering time, more efficacy for fracture in short-term clinic and better for the function of the knee. However, it increases the X-ray more frequency, and high cost in hospital, that would hinder LISS blade plate to be popular in clinic.