有限内固定结合外固定架与VSD一期治疗开放性Pilon骨折

Limited internal fixation combined with external fixation frame and VSD in one-stage treatment of open pilon fractures

目的探讨有限内固定结合外固定架＋创面VSD引流技术在开放性Pilon骨折中的治疗效果。方法对2011年2月~2015年2月采用有限内固定结合外固定架和VSD引流技术一期治疗开放性Pilon骨折23例,并进行随访,评估疗效。结果 23例患者随访6~18个月,平均12个月。骨折愈合后依据AOFAS评分,优13例、良7例、差3例,优良率为86.96%。结论有限内固定结合外固定架与创面VSD引流治疗开放性Pilon骨折可达到一期治疗的满意效果。有限内固定结合外固定架可获得良好的复位和稳定的固定,彻底清创VSD应用降低了创口感染、皮肤坏死等并发症的风险。术后骨折愈合和踝关节功能恢复临床效果满意。

Objective To discuss the curative effects of limited internal fixation combined with external fixation frame plus vacuum sealing drainage （VSD） of wound surface in the treatment of open pilon fractures. Methods 23 cases of open pilon fractures were managed by the one-stage treatment of limited internal fixation combined with external fixa- tion frame plus VSD from February 2011 to February 2015, and follow-up visits were performed to evaluate the cura- tive effects. Results The 23 cases were followed-up for 6-18 months, with the average of 12 months. After recovery, according to AOFAS scores, 13 cases were excellent, 7 cases were good, and 3 cases were bad. The excellent and good rate was 86.96%. Conclusion Limited internal fixation combined with external fixation frame plus wound surface VSD in the treatment of open pilon fractures are able to reach the satisfactory effects of one-stage treatment. Limited inter- nal fixation combined with external fixation frame is able to acquire favorable reduction and stable fixation, and VSD application of thorough debridement reduces the risks of complications such as wound infection and skin necrosis. The clinical effects of postoperative fracture healing and ankle joint function recovery are satisfactory.