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1、新疆醫(yī)科大掌醫(yī)掣蝎炙士掌位論文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舌股骨遠(yuǎn)端及脛骨近端粉碎性骨折是膝關(guān)節(jié)周圍的一種嚴(yán)重?fù)p傷，由于骨折位于干骺端，鄰近關(guān)節(jié)面，且為粉碎性，臨床治療較為棘手，是創(chuàng)傷骨科的一大難點(diǎn)。保守治療常造成對線不良、骨折不愈合及膝關(guān)節(jié)僵直Ⅲ，僅適于兒章移位不明顯或經(jīng)簡單手法即可復(fù)位的穩(wěn)定骨折嘲。為了降低其后遺癥的發(fā)生率，常需要進(jìn)行切開復(fù)位，手術(shù)治療。而股骨遠(yuǎn)端粉碎性骨折由于其解剖限制了髓內(nèi)固定系統(tǒng)的應(yīng)用，因此不能達(dá)到有效固定。雖然外固定技術(shù)治療此類骨折有時(shí)也能取得
8、良好的效果，但是長期固定會合并釘?shù)栏腥?、固定釘松動，引起骨折不愈合從而影響生活及功能圓。對于脛骨近端骨折往往由于受傷時(shí)能量較高，軟組織容易出現(xiàn)壞死、感染等并發(fā)癥∞1，同時(shí)脛骨上端脛前區(qū)軟組織少
