封闭负压引流结合外固定支架治疗开放性Pilon骨折

Vacuum Sealing Drainage Combined External Fixation in Treatment of Open Tibia Pilon Fracture

目的:探讨封闭负压引流术(vacuum sealing drainage,VSD)结合有限内固定,加外固定支架术在开放性复杂Pilon骨折应用的疗效。方法:回顾性研究我科56例开放性复杂Pilon骨折患者临床资料,治疗均采用螺钉或者克氏针等内固定器材有限固定,AO多边外固定支架跨踝关节外固定,VSD封闭创面。二期行肌(皮)瓣显微或植皮修复创面。结果:全部皮瓣成活,骨折愈合,无创面软组织并发症发生。根据Helfet评分评价患者踝关节功能恢复情况,优20例,良24例,可10例,差2例,优良率达78.6%。结论:VSD结合有限内固定加外固定支架适于全身情况欠佳的复杂开放性Pilon骨折治疗。

Objective To investigate the clinical effects of VSD combined with external fixation and limited internal fixation in treating open and complex Pilon fractures.Methods The clinical data of 56 patients with open and complex Pilon fractures were retrospectively analyzed.All patients were primarily treated with limited internal fixation and external fixation,and then the wound surface were covered with VSD.The skin transplation or local flap grafting were given later.ResultsAll flaps were survived and fractures were healed without soft tissue complications.According to the Helfet scores,the function recovery of ankle joints were excellent in 20 cases,good in 20 cases,fair in 10 cases,poor in 2 cases,the rates of excellent and good were high to 78.6%.Conclusion The combination of VSD with limited internal fixation and external fixation suits for patients with complex and open Pilon fractures,and especially for patients in a state of poor health.