Clinical Research Of Unilateral External Fixator Combined With Vacuum Sealing Drainage Treatment Of Tibiofibular Fractures Of Gustilo Type Ⅲ

Objective Comparison of the clinical efficacy of unilateral external fixation combined with vacuum sealing drainage (VSD) with unilateral external fixator combined with traditional wound dressing treatment of tibiofibular fractures of Gustilo type Ⅲ, provide a reasonable basis for clinical treatment options.Methods A retrospective study of clinical data of54cases of surgical patients treatment of tibiofibular fractures of Gustilo type Ⅲ since August2004,28cases of Gustilo type Ⅲ tibiofibular fractures were treatment in unilateral external fixation combined with vacuum sealing drainage (VSD),There were17males and11females; with an average32.5years(from21to62years);19cases were traffic accident injury,5cases were falling injury,4cases were crush injury;8cases were merge rib fracture,4cases were craniocerebral trauma,2cases were visceral injury; there were16cases of type ⅢA;9cases of Type ⅢB;3cases of Type ⅢC。26cases of Gustilo type Ⅲ tibiofibular fractures were treatment in unilateral external fixator combined with traditional wound dressing,There were16males and10females; with an average31.4years(from21to59years);17cases were traffic accident injury,6cases were falling injury,3cases were crush injury;6cases were merge rib fracture,3cases were craniocerebral trauma,2cases were visceral injury; there were17cases of type ⅢA;7cases of Type ⅢB;2cases of Type ⅢC。o From postoperative wound healing time, fracture healing time and complication rates three aspects to evaluate the clinical effect.RESULTS All the patients postoperative follow-up.1.The group of unilateral external fixation combined with vacuum sealing drainage (VSD):All the cases were followed up for10to25months.with an average of14.5months. all the wounds were closed after VSD for6to21days(average15.6days). which8cases of direct suture, 13cases of free skin graft,3cases of suture and free skin graft,4cases of skin flap; The wound healing time of18to45days (average21.5days);Fracture healing time after6to13months (average8.5months), the healing rate was100%,2cases of fracture angulation, less than8°;7cases (12holes) of needle infection, with no fixed pin loosening and fracture cases, no osteomyelitis and shortening of the limbs.2.The group of unilateral external fixator combined with traditional wound dressing:All the cases were followed up for14to32months, with an average of18.5months. All the wounds were closed after an open wound dressing treatment for10to45days(average24.5days).which6cases of direct suture,11cases of free skin graft,2cases of suture and free skin graft,7cases of skin flap; The wound healing time of24to385days (average72.23days);Fracture healing time after6to32months (average14.5months), the healing rate was100%,4cases of fracture angulation, less than8°;6cases (11holes) of needle infection,4cases of pin loosening,2cases of infected bone is not connected, with no shortening of the limbs.Conclusions unilateral external fixator combined with vacuum sealing drainage (VSD) and unilateral external fixator combined with traditional wound dressing are an effective method of treatment of tibiofibular fractures of Gustilo type Ⅲ; Unilateral external fixation combined with vacuum sealing drainage (VSD) treatment of tibiofibular fractures of Gustilo type Ⅲ, in wound healing time, fracture healing time, complication rates are better than unilateral external fixator combined with traditional wound dressing.