胫腓骨GustiloⅢ型骨折患者负压封闭引流技术联合外固定支架治疗的临床研究

目的：对负压封闭引流技术(vacuum sealing drainage，VSD)联合外固定支架治疗胫腓骨GustiloⅢ型骨折的临床效果进行评估。方法：对49例GustiloⅢ型骨折患者的治疗及随访情况进行回顾性分析，根据治疗方式分为研究组26和对照组23例，研究组采用VSD+外固定支架治疗，对照组采用外固定支架+传统换药方法治疗。结果：研究组的创面愈合时间(68.5±22.4) d、骨折愈合时间(5.4±1.7)月均显著的低于对照组的创面愈合时间(115.8±47.3) d、骨折愈合时间(7.8±2.3)月且差异均具有统计学意义(P<0.05)。研究组的创面愈细菌转阴率在术后第1、2、3个月均高于对照组，但是仅在术后第2个月两组间差异具有统计学意义(P<0.05)。研究组的踝关节优良率88.46%的高于对照组的69.57%，但两组间差异不具有统计学意义(P>0.05)。研究组的患侧肢体功能综合评价优良率92.31%的显著的高于对照组的69.57%且两组间差异具有统计学意义(P<0.05)。结论：VSD联合外固定支架治疗胫腓骨GustiloⅢ型骨折能够缩短患者创面及骨折愈合时间、对于患者肢体功能恢复也具有促进作用。

Clinical study on treatment of patients with vacuum sealing drainage combined with external fixation of the tibia and fibula fracture of Gustilo type

Objective: To evaluate the clinical effect of vacuum sealing drainage (VSD) combined with external fixator on the treatment of Gustilo type III fractures of tibia and fibula.Methods: The treatment and follow-up of 49 patients with Gustilo type III fractures were retrospectively analyzed, according to the treatment method, 26 cases were divided into study group and control group 23 cases, the study group was treated with VSD + external ifxator, and the control group was treated with external ifxation and traditional dressing change.Results: In the study group, the wound healing time was (68.5±22.4) d, fracture healing time was (5.4±1.7) months, both are signiifcantly lower than that in the control group with wound healing time (115.8±47.3) d, and fracture healing time (7.8±2.3) months, the differences was statistically significant (P<0.05). The wound healing and bacterial clearance rate in the study group in the postoperative 1, 2 and 3 months were higher than those of control group, but only in postoperative 2 months the difference between the two groups has statistical signiifcance (P<0.05). hTe excellent rate of ankle joint in the study group was 88.46%, higher than that in the control group (69.57%), but the difference between the two groups was not statistically signiifcant (P>0.05). In the study group, the rate of excellent and good rate was 92.31%, which was signiifcantly higher than that of the control group (69.57%), and the difference between the two groups was statistically signiifcant (P<0.05).Conclusion:VSD combined with external ifxation in the treatment of tibioifbular fracture of Gustilo typeⅢ can shorten the wound healing time, and for patients with recovery of limb function also has a role in promoting.