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A special instrument: the LISS tractor.

Jan Rosenkranz¹, Reto Babst

¹Chirurgische Klinik A, Kantonsspital Luzern, Schweiz.

Operative Orthopadie Und Traumatologie

|March 15, 2006

Summary

The AO distractor aids in Less Invasive Stabilizing System (LISS) plate osteosynthesis for distal femur fractures, potentially reducing surgical time. While it did not significantly alter malalignment rates in this study, it offers a valuable adjunct for fracture reduction.

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Area of Science:

Orthopedic surgery
Trauma surgery
Biomedical engineering

Background:

Distal femur fractures present challenges in achieving optimal reduction and fixation.
The Less Invasive Stabilizing System (LISS) offers a minimally invasive approach for these fractures.
Effective reduction and alignment are crucial for successful osteosynthesis and patient outcomes.

Purpose of the Study:

To evaluate the utility of the large AO distractor in facilitating reduction and retention during LISS plate osteosynthesis of distal femur fractures.
To assess the impact of the AO distractor on surgical time and alignment accuracy.

Main Methods:

The study included patients with distal femoral fractures suitable for LISS plate osteosynthesis.
The AO distractor was applied to assist in achieving correct length and alignment, with Schanz screws used for fixation.
Surgical technique involved supine positioning, standard LISS application, distractor assembly, distraction, alignment correction, and final screw insertion.

Main Results:

The AO distractor was used in 18th case onwards, with an estimated time saving of approximately 13% considering the learning curve.
Three out of 42 patients experienced postoperative varus or valgus malalignment.
No rotational malalignment was observed, and the distractor's effect on malalignment incidence was inconclusive due to sample size, though rates aligned with literature.

Conclusions:

The AO distractor is a useful tool for facilitating reduction and retention in LISS plate osteosynthesis of distal femur fractures.
While not definitively altering malalignment rates in this series, it aids in achieving desired length and alignment.
Further studies with larger cohorts may be needed to fully elucidate the distractor's impact on malalignment incidence.

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