A systematic review of the clinical and radiological outcomes of LISS plating for proximal tibial fractures

  • Toby O. SmithEmail author
  • Christopher Hedges
  • Kersten Schankat
  • Caroline B. Hing
Original Article


This study systematically reviews the evidence-base pertaining to the use of the Less Invasive Stabilization System (LISS) fixation method in the management of tibial plateau and proximal tibial fractures. An electronic database and hand search was undertaken. Study methodology was assessed using the Critical Appraisal Skills Programme tool. A total of 14 publications including 597 patients with 610 proximal tibial fractures after LISS management were reviewed. These suggest that LISS fixation is suitable for tibial plateau and proximal tibial fractures, but that there remains a high incidence of loss of reduction (14%), infection rate (7%) and delayed or non-union (4%). The literature suggests that in cases of tibial plateau fractures, additional intra-fragmentary fixation and medial buttress plates may be required. The quality of the evidence-base appears limited. Further study is recommended to improve the evidence-base and to determine the optimal strategy to manage these complex patients.


Less Invasive Stabilization System Proximal tibial fracture Tibial plateau Outcomes Systematic review 



We thank the library staff at the Norfolk and Norwich’s Sir Thomas Browne Library for their assistance in gathering the papers required for this study. We also thank the corresponding authors for their appraisal and comments on our search results.

Conflict of interest statement

No funds were received in support of this study.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Toby O. Smith
    • 1
    • 2
    Email author
  • Christopher Hedges
    • 3
  • Kersten Schankat
    • 1
  • Caroline B. Hing
    • 4
  1. 1.Institute of OrthopaedicsNorfolk and Norwich University HospitalNorwichUK
  2. 2.Faculty of HealthUniversity of East AngliaNorwichUK
  3. 3.Physiotherapy DepartmentNorfolk and Norwich University HospitalNorwichUK
  4. 4.Department of Trauma and OrthopaedicsWatford General HospitalWatfordUK

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