摘要
目的 探讨外【刮定支架结合负压封闭引流(VSD)技术治疗GustilollI型胫腓骨外放性骨折的疗效。方法2006年10月至2009年11月采卅外蚓定支架结合VSD技术治疗19例GustiloIII型胫腓骨开放性骨折患者,男14例,女5例;年龄17.62岁,平均30.1岁。肝放性损伤按Gustilo分型:ⅢA型9例,ⅢB型8例,llIC世2例。所有患者均行急诊清创、骨折复位后外固定支架固定,采用VSD技术关闭创而,待创面沽净、肉芽乍长后通过直接缝合(5例)、游离植皮(9例)或转移皮瓣(5例)等方法修复软组织创面。结果 19例患者术后获12~24个月(平均16.3个月)随访。所有患者经VSD治疗5~17d(平均9.3d)后关闭创耐,2例因创面感染、组织坏死渗出,经多次清创并更换VSD敷料后,创嘶最终通过转移皮瓣得以修复。骨折愈合时间为4~10个月(平均5.6个月)。结论 外固定支架结合VSD技术治疗Gustilofll型胫腓骨开放性骨折能住迅速有效地稳定。胃’折的同时,早期闭合创面,促进骨折愈合,减少片发症的发生。
Objective To report clinical efficacy of vacnt, m sealing drainage (VSD) and external fixation in the treatment of tibiofibular fractures of Gustih) type Ⅲ. Methods From October 2006 to November 2009. 19 cases of Gustilo type Ⅲ tibiofibular fracture were treated in our department. They were 14 men and 5 women, with an average age nf30. 1 years from 17 to 62 years). There were 9 cases of type ⅢA, 8 cases of Type ⅢB 2 cases of type mc. After emergency debridement, all the fractures were fixed with an external fixatnr following indirect reduction. The wounds were sealed with VSD. When the wounds were clean anti granulation appeared, they were repaired by direct suture (5 cases), split-thickness skin graft (9 cases) and flap transposition (5 cases). Results The 19 cases were tollowed up for 12 to 24 months, with an average of 16.3 months. All the wounds were closed 'after VSD for 5 tn 17 days. Wound infection occulTed in 2 cases and was finally repaired by flap transposition following repeated debridement and VSD. The fractures healed after 4 to 10 months (average, 5.6 months). Conclusion External fixation combined with VSD is a simple and effective treatment for tibiofibular fractures of Gustilo type Ⅲ, because it can provide not only rapid fixation hut also early wound sealing to facilitate fracture healing and reduce incidence of complications.
出处
《中华创伤骨科杂志》
CAS
CSCD
2011年第5期433-436,共4页
Chinese Journal of Orthopaedic Trauma
关键词
胫骨骨折
腓骨
骨折
开放性
外固定器
引流术
Tibial fracture
Fibula
Fracture, open
External fixator
Drainage