负压封闭辅助引流技术联合锁定接骨板外用技术治疗胫骨中下段开放骨折的临床效果  

Vacuum-assisted closure with external locking plates for treatment of open distal tibial fractures

作　　者：梁伟[1] 陈长河[1] 李冀[1] 黄星会[2] 

机构地区：[1]河北联合大学附属骨科医院创伤三科,河北唐山063000 [2]河北联合大学护理学院,河北唐山063000

出　　处：《中国骨与关节外科》2012年第5期405-408,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:目前在国内锁定接骨板常作为内固定器材使用,国外仅有少数病例报道将其作为外固定器材使用,而负压封闭辅助引流技术联合锁定接骨板外用治疗开放骨折的病例,鲜有报道。目的:探讨负压封闭辅助引流技术(vacuum-assisted closure,VAC)联合锁定板外用治疗胫骨中下段开放骨折后的临床效果。方法:2010年6月至2011年6月,我院收治胫骨中下段开放骨折患者80例,随机分为A、B两组,每组40例。A组采用负压封闭辅助引流技术联合锁定接骨板外用技术,B组采用外固定架固定术后常规换药治疗。结果:80例患者随访3～12个月,平均7.5个月。A组软组织恢复时间(13.70±1.89)d,B组(18.00±2.82)d;A组肉芽生长时间(4.90±1.10)d,B组(13.40±1.89)d,外固定架持续时间A组(14.30±1.88)d,B组(40.40±5.64)d;A组骨折愈合时间(16.10±1.85)周,B组(29.40±2.91)周;A组总住院天数(4.90±1.10)周,B组(10.90±3.28)周;A组踝关节活动度为34.40°±0.69°,B组20.20°±6.07°。数据对比分析后,A组均优于B组(P<0.05)。结论:负压封闭辅助引流技术联合锁定接骨板外用技术简单,可靠,创伤小,功能恢复快,是治疗胫骨中下段开放骨折的合理方法。Background： At present, locking plate is often used as internal fixation devices in China. There are a few of cases reported as external fixation equipment in foreign literatures. Vacuum-assisted closure （VAC） with locking plates for external fixation in the treatment of open fractures have rarely been reported. Objective： The aim of the study is to explore the clinical outcomes of VAC combined with external fixation with locking plates for treatment of open distal tibial fractures. Methods： Between June 2010 and June 2011, 80 patients with open distal tibial fractures were treated in our hospital. They were randomly divided into 2 groups （n=40）. In group A, VAC and external fixation with locking plates were applied for the treatment. In group B, the external fixator and postoperative dressing therapy were used. Results： All the patients were followed up for 7.5 months on average （range, 3 to 12 months）. Soft tissue recovery time was （13.70±1.89） d in group A and （18.00 ± 2.82） d in group B. Granulation growth time was （4.90±1.10） d in group A and （13.40±1.89） d in group B. External fixator lasted for （14.30±1.88） d in group A and （40.405.64）d in group B. Fracture healing time was （16.10±1.85） weeks in group A and （29.40±2.91） weeks in in group B. The hospital stay was （4.90±1.10） weeks in group A and （10.90±3.28） weeks in group B. Ankle joint range of motion 34.40°±0.69° in group A and 20.20°±6.07°in group B. There were significant difference of these data between the two groups （P0.05）. Conclusions： VAC combined with external fixation with locking plates is a better way to treat open middle and distal tibial fractures. The technique is simple, reliable, minimally invasive, and can achieve quick functional recovery.

关 键 词：负压 锁定接骨板 开放骨折 胫骨中下段 

分 类 号：R687.3[医药卫生—骨科学]