VSD联合钢板内固定治疗胫腓骨开放性骨折的疗效观察

目的：观察VSD联合钢板内固定治疗胫腓骨开放性骨折的临床效果。方法：选取本科2009年2月-2012年6月收治的30例胫腓骨开放性骨折患者,按照Gustilo分型,Ⅱ型骨折20例,ⅢA型骨折8例,ⅢB型骨折1例,ⅢC型骨折1例,均急诊行清创、VSD联合钢板内固定治疗,持续负压引流7～10d,伤口肉芽组织生长良好后行植皮或皮瓣修复创面。结果：随访12～24个月,创面中完全愈合30例,无感染病例,骨折骨性愈合28例,骨折延迟愈合2例,再行植骨术,无截肢病例。结论：VSD能够促进肉芽组织的生长,加速创面的愈合,降低伤口的感染率,缩短治疗时间及减轻患者经济负担等优点,彻底清创后,采用VSD联合钢板内固定治疗胫腓骨开放性骨折是一种安全有效的治疗方法。

The Clinical Effect of Open Fractures of Tibia and Fibula by VSD Combine with Internal Fixation

Objective：To observe the clinical effect by VSD combine with plate internal fixation for open fractures of tibia and fibula.Method：30 cases of patients were treated with open fractures of tibia and fibula were selected from February 2009 to June 2012,20 patients of type Ⅱ,8 patients of type Ⅲ A,1 patient of type Ⅲ B,1 patient of type Ⅲ C（Gustilo classification）.All patients were treated by VSD combined with internal fixation after debridement,and were continuing attracted for 7 to 10 days using vacuum sealing drainage,when granulation tissue grew well,skin grafting or skin flap repairing was done.Result：All cases were followed up for 12 to 24 months,30 cases of wound completely healed without infection,28 cases of patients with fracture bone healing,2 cases delayed healing,further bone grafting,no amputations.Conclusion：The vacuum assisted closure technology can promote the growth of granulation,promote wound healing,reduce wound infection rate,shorten the course of the disease,and reduce health care cost, etc.After thorough debridement,VSD combined with internal fixation is a safe and effective method to treat open fracture of tibia and fibula.