The LISS plate is an internal fixator used as an extramedullary splint, fixed to the two main fragments, leaving the intermediate fracture zone untouched. Anatomical reduction of intermediate fragments is neither sought nor necessary.
Direct manipulation of intermediate fragments would risk disturbing their blood supply. If the soft-tissue attachments to these fragments are preserved, and the fragments are generally aligned, healing is unimpaired.
Any fractures of the articular block needs to addressed first under direct vision using standard techniques of interfragmentary compression. Alignment of the main shaft fragments can then be achieved indirectly, using various aids before application of the plate.
The LISS plate is commonly inserted using minimally invasive techniques, leaving the soft tissues intact around the fracture site. Incisions are made proximally and distally, and the LISS plate is inserted into a submuscular tunnel. This normally requires image intensifier monitoring.
Mechanical stability is adequate for gentle functional rehabilitation and results in satisfactory indirect healing (callus formation) of the diaphysis.
A common failure of the LISS is seen when a simple plane fracture is treated with the relatively flexible LISS plate and left with a gap. This can result in a high rate of nonunion.