• Philip J Kregor, James A Stannard, Michael Zlowodzki, and Peter A Cole.
• Division of Orthopedic Trauma, Department of Orthopedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232, USA. philip.kregor@vanderbilt.edu
• J Orthop Trauma. 2004 Sep 1; 18 (8): 509-20.

ObjectiveTo summarize the complications and early clinical results of 123 distal femur fractures treated with the Less Invasive Stabilization System (LISS; Synthes, Paoli, PA).DesignRetrospective analysis of prospectively enrolled patients.SettingTwo academic level I trauma centers.Subjects And ParticipantsOne hundred nineteen consecutive patients with 123 distal femur fractures (OTA type 33 and distal type 32 fractures) treated by 3 surgeons. One hundred three fractures (68 closed fractures and 35 open fractures) in 99 patients were followed up at least until union (mean follow-up = 14 months, range: 3-50 months).InterventionSurgical reduction and fixation of distal femur fractures.Main Outcome MeasurementsPerioperative complications, radiographic union, infection rate, loss of fixation, alignment, and range of motion.ResultsNinety-six (93%) of 103 fractures healed without bone grafting. All fractures eventually healed with secondary procedures, including bone grafting (1 of 68 closed fractures and 6 of 35 open fractures). There were 5 losses of proximal fixation, 2 nonunions, and 3 acute infections. No cases of varus collapse or screw loosening in the distal femoral fragment were observed. Malreductions of the femoral fracture were seen in 6 fractures (6%). The mean range of knee motion was 1 degrees to 109 degrees .ConclusionsTreatment of distal femur fractures with the LISS is associated with high union rates without autogenous bone grafting (93%), a low incidence of infection (3%), and maintenance of distal femoral fixation (100%). No loss of fixation in the distal femoral condyles was observed despite the treatment of 30 patients older than 65 years. The LISS is an acceptable surgical option for treatment of distal femoral fractures.

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