Clinical Efficacy Of External Fixation Associated With Limited Internal Fixation And VSD For Gustilo Ⅱ、Ⅲ Fracture By Staging Method

Objective:To explore the clinical effects of external fixation associated with limited internal fixation and vacuum-sealing drainage on Gustilo grade Ⅱ, Ⅲ fractures.Methods:From January 2012 to December 2013,13 cases of Gustilo Ⅱ and Ⅲ fractures were treated by external fixator combined with limited internal fixation and VSD.They are 11 men and 5 women. They are 3 cases of type Gustilo II and 10 cases of Gustilo III. After emergency debridement, all the fractures were fixed an external fixator combined with limited internal fixation. The wounds were sealed with VSD.Results:The 13 cases were followed up for 6 to 18 months, with an average of 12 months. 12 cases were healed by split-thickness skin graft or flap transposition at the second phase. Wound infection occurred in 1 case and was finally repaired by split-thickness skin graft following debridement and VSD. Pin tract infection occurred in 4 cases and were controlled by dressing.Schanz screw loose occurred in 5 cases until the forth month follow-up period. The 13 cases had obtained bone union and the healing time was from 8 to 18 months.Conclusion:To Gustilo Ⅱ and Ⅲ fractures were treated by using timeliness and staging method can help properly assess articular fractures and soft tissue injury. External fixator combined with limited internal fixation and VSD by phased application not only can accelerate the bone union and tissue repair but also reduce complications, reduce the amputation rate and shorting treatment time. So external fixation associated with limited internal fixation and vacuum-sealing drainage is a effective treatment for Gustilo grade Ⅱ, Ⅲ fractures.