LISS-Tractor. Combination of the less invasive stabilization system (LISS) with the AO distractor for fractures of the distal femur and proximal tibia

Minimally invasive plate osteosynthesis (MIPO) in conjunction with the less invasive stabilization system (LISS) first requires reduction and retention of the fracture using such a ids as externa I fixation, distractors, and percutaneous reduction clamps before the plate can be applied. Based on the open indirect "biological" technique of osteosynthesis, the LISS was combined with an AO distracter (IISS tractor) integrated into the LISS plate. This made reduction possible against the plate before final fixation of the LISS plate. The LISS tractor concept was validated in three patients and we present the technique here. No malalignments > 5 degrees occurred, Fluoroscopy lasted 3.0 min (range: 2.1-4.5) and the operation 125 min (range: 90-150). Modification of the well-known LISS technique by integrating the distracter into the LISS plate to simplify reduction and to provide temporary retention of th e fracture has the potential to reduce the fluoroscopy time, the operation time,the rate of malalignments, and the learning cu rye for this MIPO technique.