Treatment Of Leg Open Fracture Early By Combining Vacuum Sealing Drainage With External Fixation

Objective Leg open fracture has often serious complicated woundwith soft tissue defect and tissue necrosis.The principle of early treatmentis that try to close wound primarily after thorough debridement and coverimportant structures such as nerve，blood vessel，tendon and bone. Reduceand stabilize fracture Simultaneously.This paper aimed to explore theclinical treatment effect of open fractures of leg were fixed by externalfixation combined vacuum sealing drainage.Methods36cases with open fractures of leg were treated in our studyfrom January2009to June2011.36patients were all debridedcompletely,the tibia fracture was reduced and fixed by external fixationand vaccum sealing drainage(VSD).Covering the wound surface with freeskin graft,flap transfer or free myocutaneous flap when wound surfacewas clean and fresh.Accrding to Johner-Wruhs method was evaluatedclinical outcomes.Results33cases graft were survive,2cases graft had a litte necrosis atthe edge,yet they were healed completely after dressing change,1case graft had necrosis seriously,it was healed completely after free skingrafted.36patients fracture were all healed up. Johner-Wruhs method inaccordance with the evaluation function,ⅢA was good rate of94.12%.ⅢB was good rate of83.33%.ⅢC was good rate of57.14%.Conclusion External fixation combine with VSD treat open fracturesof leg have several advantages:reducation and fixation fracture,effectivesealing wound surface,promote granulation tissue’s growth,avoidinfection.These advantages create good conditions for furthertreatment.This way should be shorten the treatment period and achievedgood effect.