Distal femur Complete articular fracture, multifragmentary articular

Open reduction internal fixation (ORIF); less invasive stabilization system (LISS)

ORIF - less invasive stabilization system (LISS)

Indication summary: More distal metaphyseal fractures, articular fracture displaced, Surgeon's preference

Skill: Highly experienced and skilled surgeon
Equipment: Full specialized surgical and imaging resources

Condylar LCP vs. LISS
The LISS, and Condylar LCP are the only viable options. There is no clear evidence of the superiority of one implant option over the other.  Both the LISS and condylar LCP are “internal” locked fixators. They provide excellent biomechanical stability of the distal femoral segment, even in osteoporosis. The surgeon must be familiar with the techniques of locked plating.

Indications

  • All complete multifragmentary articular 
  • Closed and open fractures

Contraindications

  • Polytrauma patient in unstable condition
  • Medically unfit for surgery

Advantages

  • Definitive procedure
  • The articular surface can be reduced
  • Restoration of mechanical axis
  • Restoration of femoral rotation
  • Fracture stabilization allows early patient mobilization
  • Can be used in cases of pulmonary compromise
  • May reduce risk of osteoarthritis

Disadvantages

  • Risk of condylar malreduction
  • Demanding surgical procedure
  • Risk of infection
  • Risk of implant related complications
  • Greater blood loss

Legend

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

Appendix

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v1.0 2008-12-03