一期内固定联合腓肠神经皮瓣治疗开放性胫骨远端骨折伴软组织缺损的临床效果  

Clinical effect of one-stage internal fixation combined with sural neurocutaneous flap in the treatment of open distal tibial fracture and soft tissue defect

作　　者：王昌绚 李家伟[1] 刘晓齐 陈阳斌[1] WANG Changxuan;LI Jiawei;LIU Xiaoqi;CHEN Yangbin(No.4 Orthopedics Department,Ankang Central Hospital,Ankang 725000,China)

机构地区：[1]陕西省安康市中心医院骨四科,陕西安康725000

出　　处：《临床医学研究与实践》2022年第5期16-18,30,共4页Clinical Research and Practice

基　　金：安康市科学技术研究发展计划项目(No.AK2020-SFZC-11)。

摘　　要：目的探讨一期内固定联合腓肠神经皮瓣治疗开放性胫骨远端骨折伴软组织缺损的临床效果。方法选取于我科2010年2月至2020年2月行手术治疗的48例开放性胫骨远端骨折伴软组织缺损患者作为研究对象,随机将其分成A组与B组,各24例。A组给予一期内固定联合腓肠神经皮瓣治疗,B组给予一期软组织清创负压封闭引流(VSD)覆盖创面,待软组织恢复后二期行内固定的常规治疗。比较两组患者的感染率、住院时间、骨折愈合率、踝关节功能(Kofoed)评分。结果A组的感染率低于B组,住院时间短于B组,骨折愈合率、Kofoed评分均高于B组,差异具有统计学意义(P<0.05)。结论一期内固定联合腓肠神经皮瓣治疗开放性胫骨远端骨折伴软组织缺损患者的临床效果显著,可显著降低感染率,缩短住院时间,提高骨折愈合率及踝关节功能,值得临床推广应用。Objective To investigate the clinical effect of one-stage internal fixation combined with sural neurocutaneous flap in the treatment of open distal tibial fracture and soft tissue defect.Methods A total of 48 patients with open distal tibial fracture and soft tissue defect who underwent surgical treatment in our department from February 2010 to February 2020 were selected as the research objects,and the patients were randomly divided into group A and group B,with 24 cases in each group.The group A was treated with one-stage internal fixation combined with sural neurocutaneous flap,the group B was treated with one-stage soft tissue debridement vacuum sealing drainage(VSD)to cover the wound,and the conventional treatment of two-stage internal fixation was performed after the soft tissue recovered.The infection rate,hospital stay,fracture healing rate and ankle function(Kofoed)score were compared between the two groups.Results The infection rate in the group A was lower than that in the group B,hospital stay was shorter than that in the group B,fracture healing rate and Kofoed score were higher than those in the group B,and the differences were statistically significant(P<0.05).Conclusion One-stage internal fixation combined with sural neurocutaneous flap in the treatment of patients with open distal tibial fracture and soft tissue defect has significant clinical effect,it can significantly reduce the infection rate,shorten the hospital stay,improve the fracture healing rate and ankle function,which is worthy of clinical promotion and application.

关 键 词：一期内固定 腓肠神经皮瓣 开放性胫骨远端骨折 软组织缺损 

分 类 号：R683.42[医药卫生—骨科学]