Abstract
Background: To analyse the effectiveness and complications of Less Invasive Stabilisation System (LISS plate) in the management of peri-prosthetic femoral fractures.
Materials and methods: We present a study of 18 peri-prosthetic femoral fractures around hip arthroplasty (16 females and 2 male patients) treated with LISS plate between September 2001 to February 2005. The average age of the patients was 81.6 years. Twelve patients had significant co-morbidities pre-operatively. All the fractures were classified according to the Vancouver classification for Peri-prosthetic fracture of femur. Ten were classified as type B1, two as type B2 and six as type C. Eleven fractures were around total hip replacement and seven were around hemi-arthroplasty (four cemented and 3 uncemented). Partial weight bearing started early post-operatively. Full weight bearing varied between 5-6 weeks depending on clinical and radiological status. The patients were followed up untill fracture union.
Results: Three patients died during the follow-up period owing to unrelated causes. The average follow up period was 11.7 months. All the remaining fifteen patients had satisfactory fracture union although one patient required further LISS plate following a fall 17 days postoperatively and another one patient developed low grade deep infection with a chronic sinus. It was noted that in one patient, plate had lifted off the bone at the proximal end with no loss of reduction of the fracture. Three patients were noted to have mild to moderate discomfort around the prominent implant. No implant breakage noted.
Conclusions: Even though LISS plate was originally designed for distal femoral fracture treatment, it appears to be very promising device in the treatment of peri-prosthetic femoral fractures (Type B1, Type C and medically unfit patients with Type B2 for stem- revision) with osteoporotic bone in elderly patients. Early mobilization is a key feature. This system involves minimally invasive approach, stable construct without need for primary bone grafting.
Correspondence should be addressed to Mr Carlos Wigderowitz, Senior Lecturer, University Department of Orthopaedic and Trauma Surgery, Ninewells Hospital and Medical School, Dundee DD1 9SY.
