[1]王序全,吴雪晖,罗飞,等.微创内固定系统在膝关节周围骨折治疗中的初步应用[J].陆军军医大学学报(原第三军医大学学报),2008,30(08):671-674.
　WANG Xu-quan,WU Xue-hui,LUO Fei,et al.Less invasive stabilization system for fracture around knee joint[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(08):671-674.
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微创内固定系统在膝关节周围骨折治疗中的初步应用(/HTML )
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陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
30卷
期数:
2008年第08期
页码:
671-674
栏目:
论著
出版日期:
2008-04-30

文章信息/Info

Title:
Less invasive stabilization system for fracture around knee joint
作者:
王序全; 吴雪晖; 罗飞; 谢肇; 张劲松
第三军医大学西南医院骨科，全军矫形外科中心
Author(s):
WANG Xu-quan;  WU Xue-hui;  LUO Fei;  XIE Zhao;  ZHANG Jin-song
Department of Orthopedics, Orthopedic Center of PLA, Southwest Hospital, Third Military Medical University
关键词:
骨折内固定; 膝关节; 微创内固定系统
Keywords:
racture fixation;  knee;  less invasive stabilization system
分类号:
R616;R683.42;R687.32
文献标志码:
A
摘要:
目的 探讨微创内固定系统（less invasive stabilization system，LISS）治疗股骨远端及胫骨近端骨折的临床疗效。 方法 回顾性分析2005年3月至2007年5月应用LISS技术治疗的12例膝关节周围骨折的病例资料。男性8例，女性4例，年龄24～47岁，平均36.5岁。股骨远端骨折7例，胫骨近端骨折5例。按国际内固定研究协会（Association for the study of internal fixation， AO/ASIF）分型：股骨远端A2型4例、C1型2例、C2型1例；胫骨近端A2型2例、C1型2例、C2型1例。均为新鲜闭合性骨折。受伤至手术时间3~15 d，平均7.5 d。除关节内骨折有限切开复位外，其他骨折均行间接复位，经小切口肌肉下骨膜外植入LISS，导向器导引下经皮自钻自攻皮质螺钉锁定。 结果 平均手术时间58 min（40~90 min），平均出血量80 ml（60~120 ml），均未植骨。随访6~18个月，平均11个月，骨折全部愈合。X线愈合时间平均13.2周（11~24周），完全负重时间平均12.7周（8~20周）。术后无1例感染、螺钉脱落、固定失效等发生。1例术后发生关节面复位丢失，术后关节活动范围96°～120°。以Johner评价标准进行评估：优7例，良4例，可1例。 结论 LISS可保护骨膜及骨折部位血运，促进骨折愈合和功能恢复，是一种有效治疗膝关节周围复杂性骨折的新方法。
Abstract:
Objective To discuss the clinic therapeutic effect of less invasive stabilization system (LISS) in treating distal femoral fracture and proximal tibial fracture.  Methods Twelve cases of fracture around knee joint applying LISS technology for treatment from March 2005 and May 2007 were retrospectively analyzed, including 7 cases of distal femoral fracture and 5 proximal tibial fracture. The patients, 8 males and 4 females, were 24-27 years old (average 36.5). According to the AO/ASIF classification, 4 cases were A2-type distal femoral fracture, 2 C1-type and 1 C2-type; 2 cases were A2-type proximal tibial fracture, 2 C1-type and 1 C2-type. All cases were fresh closed fractures. The time from injured to operation was 3-15 days (average 7.5 days). Except internal articular fracture was treated with limited open reduction, other fractures were treated with indirect reduction. LISS was implanted from minor incision extraperiosteally and locked with the lower percutaneous selfdrilling and selftapping cortical screw under the guider.  Results The average operation time was 58 min (40-90 min) and the average bleeding was 80 ml (60-120 ml). No bone grafting was required in all cases. The follow-up time was 6-18 months (average 11). All fractures recovered. The healing time under X-ray examination was 13.2 weeks in average (range from 11 to 24 weeks) and the full-load time was 12.7 weeks in average (8-20 weeks). No postoperative infection or screws loosening or failed fixation occurred. Joint surface reduction missing after reduction occurred in 1 case and its motion range of joint after operation was 96° to 120°. According to Johner evaluation standard: 7 cases achieved excellent outcome, 4 good and 1 average.  Conclusion LISS can protect periosteum and the blood circulation at fracture site, and accelerate fracture healing and function recovery. LISS is an new effective method for complex fracture around knee joint.

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更新日期/Last Update: 2008-04-28