外固定支架结合VSD技术治疗开放性胫腓骨骨折伴软组织缺损患者的疗效观察

目的 探讨外固定支架结合负压封闭引流（VSD）技术治疗胫腓骨开放性骨折伴软组织缺损的临床疗效.方法 对2009年6月～2013年1月收治的26例胫腓骨开放性骨折伴软组织缺损患者,采用单边外支架固定结合VSD治疗,清创后骨折用单边外支架固定;创面或创腔用VSD覆盖,持续负压吸引;5～9天后拆除VSD行二期缝合、游离植皮或皮瓣转移修复.并对软组织愈合情况、骨折时间及有无并发症进行疗效评价.结果 随访6～37个月,26例创面二期术后均完全愈合;24例骨折一期愈合;2例骨折延迟愈合;无骨折不愈合;骨愈合时间4.5～9个月,平均6个月;无深部感染及骨髓炎发生.结论 外固定支架结合VSD技术治疗开放性胫腓骨骨折伴软组织缺损安全可靠,既达到了对骨折断端的牢固固定,又最大限度的减少了对软组织的损害.安全有效的封闭创面、缩短创面修复时间,减少并发症.

External fixation combined with vacuum sealing drainage technique in treatment of tibia and fibula open fractures with skin and soft tissue defects

Objective To summarize the application of external fixation and vacuum sealing drainage technique in treatment of tibia and fibula open fractures with skin and soft tissue defects.Methods External fixation combined with vacuum sealing drainage（VSD）was used to repair skin defects of lower leg with tibia and fibula open fractures in 26 patients.First a positive therapy with VSD was used in 5-7days after debridement,fracture reduction and external fixation.After the flesh granulation tissues grew and infections in contro1 defects were repaired by skin grafts or island flap.Results During the follow-up of 6-37 months,the wounds of 26 patients postoperative were healed.All cases united by range 4.5-9months,no deep infection and no recurrence of osteomyelitis.Conclusion Application of external fixation combined with vacuum sealing drainage technique is an effective method for treatment of lower leg fracture with frustration of skin and soft tissue defects.