Early results with the new internal fixator systems LCP and LISS: a prospective study.

The Locking Compression Plate (LCP) and the Less Invasive Stabilisation System (LISS) are new implants with angular stability developed by the AO/ASIF. They offer an alternative for internal fixation in complex intra-articular fractures and high-energy diaphyseal fractures of the long bones. The new system was used in a prospective study to treat 113 patients (76 women, 37 men; average age: 53.1 years) with 122 injuries (multifragment shaft fractures or complex intra-articular, delayed/ non-union, malunion) from October 2002. Of these, 13 affected the humerus, 20 the radius, 2 the ulna, 21 the femur, 42 the tibia, 10 the fibula, 2 the acetabulum and 12 the calcaneus. Because of severe concomitant injuries, 18 fractures were first treated with an external fixator and definitively stabilised more than two weeks after the injury. Thirty-one patients were operated on after failure of other implants and non-union. Clinical and radiographic findings as well as complications were followed prospectively over a mean period of 20 months (range: 13 to 30). One patient was lost to follow-up. A total of 112 patients underwent a standardised follow-up examination. The outcome correlated with the severity of the fracture, anatomic reduction, adequate positioning of the plate and concomitant injuries. Despite the large number of open and comminuted fractures, no serious complications such as deep infections, vascular lesions, deep venous thrombosis or non-unions were noted. We found the new internal fixator system to be a safe and reliable procedure. It offers numerous fixation possibilities and has proven its value in complex fracture situations and in revision operations. A good knowledge of biomechanics is essential as well as precise preoperative planning.

Non-monomelic synchronous primary multicentric chondrosarcoma: a case report.

We report a patient with simultaneous presentation of two histologically grade 2 conventional chondrosarcomas non-derived from pre-existing cartilaginous lesions, in the absence of pulmonary or visceral involvement. One tumour was located at the right proximal femur and the other one at the right scapula. There was no evidence of local recurrence or pulmonary or visceral involvement three years and a half after total scapulectomy and resection of the proximal third of the femur. To the best of our knowledge, this is the first report of a patient with two non-monomelic synchronous chondrosarcomas arising in two previously normal bones of the skeleton. Such cases are often difficult to differentiate from metastatic disease.