| BackgroundTibiofibular fracture of Gustilo type Ⅲ has always been a difficult and hot issue in orthopedics,among which soft tissue reconstruction and wound closure are important links.In recent years,vacuum-assisted closure(VAC)technology has shown advantages in various wound repairs,and the role of antibiotic-loaded bone cement in the prevention and treatment of bone infection is clear,but the combined application of the two to tibiofibular fracture of Gustilo type Ⅲ is still rare,and there is a lack of systematic efficacy evaluation.This study combined the application of two techniques to provide a new idea for the treatment of tibiofibular fracture of Gustilo type Ⅲ.ObjectiveBy comparing the clinical efficacy of antibiotic-loaded bone cement combined with VAC and single VAC in the treatment of tibiofibular Gustilo type Ⅲ fracture,the application value of antibiotic-loaded bone cement combined with VAC in the treatment of tibiofibular fracture of Gustilo type Ⅲ was discussed,which provided evidence for the next clinical application.MethodsA retrospective analysis was performed on 40 patients with tibiofibular fracture of Gustilo type Ⅲ admitted to the Department of Trauma Orthopedics of the Second Hospital of Shandong University from May 2020 to October 2021,and were divided into experimental group and control group according to the treatment method,with 20 cases in each group.Among them,the experimental group(14 males,6 females,age 26～64 years old):antibiotic-loaded bone cement combined with VAC treatment.The control group(13 males,7 females,aged 24～68 years old)was treated with single VAC treatment.The baseline data,perioperative data,wound culture and repair,fractures,and limb recovery,blood test indexes and patient satisfaction of the two groups were counted and compared.ResultsBaseline data and preoperative indicators were comparable between the two groups.In the comparison of perioperative data,the experimental group was better than the control group in terms of preoperative time,number of operations,hospital stay and treatment cost in the second stage,and the difference was statistically significant(P<0.05).In the comparison of wound bacterial culture,the negative rate of bacterial culture in the experimental group was higher than that in the control group(P<0.05).Compared with the wound healing status,the wound healing time,exudation rating and granulation rating of the experimental group were better than those of the control group,and the difference was statistically significant(P<0.05).In the comparison of fracture healing and limb function,Fracture healing and limb function in the experimental group were better than those in the control group,and the difference was statistically significant(P<0.05).For the comparison of blood test results,the blood test results of the two groups were lower than before,and the blood test results of the experimental group before the second stage surgery were lower than those of the control group,and the difference was statistically significant(P<0.05).In the comparison of satisfaction,the satisfaction of patients in the experimental group was higher than that in the control group,with obvious statistical differences(P<0.05).There were no significant statistical differences in other indicators between the patients in the two groups(P>0.05).ConclusionIn the treatment of tibiofibular fracture of Gustilo type Ⅲ,compared with single VAC treatment,antibiotic-loaded bone cement combined with VAC can shorten the treatment cycle,reduce treatment costs,effectively control wound infection,promote granulation tissue growth and soft tissue repair,accelerate fracture healing and reduce fracture complications,improve postoperative limb function,reduce blood inflammation indicators,and have higher patient satisfaction.In summary,antibiotic-loaded bone cement combined with VAC has significant advantages and is an ideal treatment for patients with tibiofibular fracture of Gustilo type III,which is worthy of clinical promotion and application. |
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