Treatment of tibiofibular fractures of Gustilo type Ⅲ by vacuum, sealing drainage and external fixation

Objective To report clinical efficacy of vacuum sealing drainage(VSD)and external fixation in the treatment of tibiofibular fractures of Gustilo type Ⅲ. Methods From October 2006 to November 2009,19 cases of Gustilo type Ⅲ tibiofibular fracture were treated in our department.They were 14men and 5 women,with an average age of 30.1 years(from 17 to 62 years).There were 9 cases of type ⅢA,8 cases of Type ⅢB 2 cases of typeⅢC.After emergency debridement,all the fractures were fixed with an extemal fixator following indirect reduction.The wounds were sealed with VSD.When the wounds were clean and 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 followed up for 12 to 24 months,with an average of 16.3 months.A11 the wounds were closed'after VSD for 5 to 17 days.Wound infection occurred 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 but also early wound sealing to facilitate fracture healing and reduce incidence of complications.