单侧外固定支架结合负压封闭引流技术治疗胫腓骨Gustilo Ⅲ型骨折的疗效  

Clinical outcome of unilateral external fixator combined with closed negative pressure drainage technology in the treatment of tibiofibula Gustilo Ⅲ type fracture

作　　者：董吴平 

机构地区：[1]海南医学院附属医院创伤医学中心,海南海口570105

出　　处：《山东大学学报（医学版）》2015年第9期86-89,共4页Journal of Shandong University:Health Sciences

摘　　要：目的研究单侧外固定支架结合负压封闭引流技术(VSD)治疗胫腓骨GustiloⅢ型骨折的临床疗效。方法从2010年7月至2015年4月我科收治的胫腓骨GustiloⅢ型骨折患者中选取57例为观察组,行单侧外固定支架结合VSD治疗;选取2006年7月至2010年6月在我科行切开复位钢板内固定术的同类患者59例为对照组。观察两组平均骨性愈合时间、住院时间、术中出血量及术后并发症的发生情况。所有患者随访半年,观察两组的疗效。结果观察组平均骨性愈合时间(180.65±30.36)d、住院时间(27.84±3.87)d、术中出血量(393.56±12.09)m L,分别低于对照组(340.00±40.51)d、(46.27±4.84)d、(545.36±50.40)m L,差异有统计学意义(P均<0.05)。观察组骨髓炎发生率1.75%、浅表感染率5.26%、畸形愈合发生率0.00%,分别低于对照组11.86%、21.05%、8.47%,差异有统计学意义(P均<0.05)。观察组疗效优者占比80.70%、优良率91.23%,均分别高于对照组的61.02%、77.97%,差异有统计学意义(P均<0.05)。结论单侧外固定支架结合VSD治疗胫腓骨GustiloⅢ型骨折,不仅有利于骨折愈合,而且可缩短患者住院时间并减少并发症的发生。Objective To explore the clinical outcome of unilateral external fixator combined with vacuum sealing drainage （VSD） technology in the treatment of tibiofibula Gustilo Ⅲ type fracture. Methods A total of 57 patients who were treated with unilateral external fixator combined with VSD from July 2010 to April 2015 were taken as observation group, and 59 patients who were treated with open reduction and plate fixation from July 2006 to June 2010 were selected as control group. The average osseous healing time, length of hospital staying, intraoperative blood loss and postoperative complications of the two groups were observed. All the patients were followed up for half a year. Results The average osseous healing time [ （ 180.65 ± 30.36 ） d ], length of hospital staying [ （ 27.84 ± 3.87 ） d ], intraoperative blood loss [ （393.56 ± 12.09 ） mL] in observation group were significantly lower than those of control group （ 340.00± 40.51 ） d, （46.27 ± 4.84 ） d and （ 545.36 ± 50.40 ） mL, all P 〈 0.05 ]. The osteomyelitis rate （ 1.75 % ）, superficial infection rate（5.26% ） and malunion rate（0.00% ） in observation group were respectively lower than those in control group （ 11.86%, 21.05%, 8.47%, all P 〈 0.05 ）. The rates of good and excellent/good in observation group were 80.70% and 91.23%, which were significantly higher than those in control group （61.02% and 77.97%,all P 〈 0.05 ）. Conclusion Unilateral external fixator combined with VSD is a good way to treat tibiofibula Gustilo Ⅲ type fracture, which is beneficial to fracture healing and can reduce the length of hospital stay and complications.

关 键 词：单侧外固定支架 负压封闭引流技术 GustiloⅢ型骨折 胫腓骨 

分 类 号：R683.42[医药卫生—骨科学]