Clinical Research Of External Fixator Combined With Vacuum Sealing Drainage Treatment Of Tibiofibular Fractures Of Gustilo Type ?A And ?B

Objective: Treatment of tibiofibula Gustilo ? A and B type fracture,appl ication of external fixator combined closed negative pressure drainage(VSD)te chnology and external fixator combined traditional wound dressing,compare the clinical curative effect.Provide the basis for selecting rational treatment in clin ical work.Methods:A retrospective analysis of 52 cases admitted in our hospital orth opaedic tibiofibula Gustilo ? the clinical data of patients with type A,B fract ures,from July 2015 to June 2016.Treatment of 26 patients with external fixat or combined with the closed negative pressure drainageinage(VSD)technology(Hereinafter referred to as "VSD").18 cases of male,8 cases of women;Aged19 to 64 years old,average 34.7 years old;The cause of the injury: 17 cases of traffic accident injury,5 cases of crush injury,2 cases of farming injury,2cases falling injury;4 cases of merger rib fractures,2 cases of humerus fractur e,3 cases of femoral fractures.Gustilo classification:type ? A 15 cases;type ?B 11 cases.In addition,the treatment of 26 patients with external fixator combi ned with traditional wound dressing(hereinafter referred to as the "treatment gr oup"),Among them,17 were male,female 9 cases;Aged 20 to 61 years old,a verage 36.3 years old;The cause of the injury: 19 cases of traffic accident inju ry,3 cases of crush injury,2 cases of farming injury,1 cases falling injury;3cases of merger rib fractures,2 cases of humerus fracture,1 cases of femoral fr actures;Gustilo classification:type ? A 19 cases;type ? B 7 cases;To obtain da ta through recording and follow-up,follow-up time begins in patients discharge d from the hospita,ended in diagnosis of fracture healing.For wound healing ti me,complications evaluation,fracture healing time and the incidence of puno f unctional score[1]data in two groups of patients.By comparing the clinical curat ive effect of two methods,in the treatment of tibiofibula Gustilo ? A,Gustilo? type B fractures.Results:This study,52 patients received follow-up.The external fixator com bined with the closed negative pressure drainageinage(VSD)technology group:The patients were followed up for 12-25 months(mean 16 months),This grou p of patients treatment with VSD 1-4 times,7-26days(An average of 14.7 day s);The wound healing time 19-42 days(mean 29.31 days);Postoperative fracture healing time was 6 to 14 months(mean 7.92 months),the healing rate was 100%,no fracture angulation cases;Wound infection in 2 case,needle infection i n 5 cases(9 holes),3 cases of loose pins,no pins broken cases,no cases of osteomyelitis and shortening of the limbs.According to the puno postoperative function assessment: 14 cases of Excellent,7 cases of good,The excellence rat e was 80.77%.The external fixator combined traditional wound treatment groups:Postoperative follow-up 12-29 months(average 16.7 months),This group of pati ents with wound dressing therapy 12-45 days after the closing wound(an aver age of 27 days);The wound healing time 21-182 days(mean 46.17 days);Posto perative fracture healing time of 6 to 17 months(average 8.13 months),the fr acture endding angled for 5 cases,degrees are less than 8 degree,Healing rate was 100%;Needle infection in 5 cases,7 cases of infection(11 holes),loose pi ns 4 cases,No pins broken cases,no cases of limb shortening,no bone nonuni on cases,1 case of osteomyelitis.According to the postoperative functional asse ssment of puno:12 cases of Excellent,8 cases of good,The excellence rate was76.9%.Conclusion: External fixator combined with the closed negative pressure d rainageinage(VSD)and external fixator combined with traditional wound dressi ng,is effective therapy in the treatment of tibiofibula Gustilo type ? A?B fr acture.External fixator combined with the closed negative pressure drainageinage(VSD)in the treatment of tibiofibula Gustilo type ? A?B fractures in woun d healing time,complications evaluation is superior than the treatment of tradit ional external fixator combined wound dressing therapy,No obvious difference was found between the two in terms of fracture healing time and postoperative function.