目的：通过软组织愈合情况、骨折时间检测分析外固定支架结合负压封闭引流( VSD)技术治疗胫腓骨开放性骨折伴软组织缺损疗效。方法本院2013年10月~2016年8月收治28例胫腓骨开放性骨折伴软组织缺损患者，采用单边外支架固定结合VSD治疗，对软组织愈合情况、骨折愈合时间及有无并发症进行疗效评价。结果两组患者经治疗后软组织及骨折都得到一定愈合，治疗组软组织愈合时间是(15．1±3．3)天，对照组软组织愈合时间(48．5±4．2)天，两者相比差异具有统计学意义(P<0．01)。此外，与对照组相比，治疗组骨折愈合时间显著下降，差异具有统计学意义(P<0．01)。治疗组20例患者出现深部感染1例，骨髓炎无；对照组8例患者出现深部感染4例，骨髓炎1例。结论外固定支架结合负压封闭引流( VSD)技术可有效地治疗胫腓骨开放性骨折伴软组织缺损，此外还可以大大降低并发症发生风险。%Objective To investigate the external fixator combined with vacuum sealing drainage ( VSD) technique in the treatment of open tibiofibular fracture with soft tissue defect of the clinical curative effect. Methods 28 cases of tibia and fibula fracture with soft tissue defect were recruited from October 2013 to August 2016which were treated by single edge bracket fixation combined with VSD treatment, debridement after fracture with unilateral external fixator;wound and the wound cavity covered with VSD,continuous suction;5 to 9 days after removal of VSD,secondary suture and free skin grafting or flap transfer for repairing. And the soft tissue healing,fracture time and have no complications were evaluated. Results two groups of patients with the treatment of soft tissue and bone fracture have been a healing,treatment group of soft tissue healing time is (15. 1 ± 3. 3) days,control group of soft tissue healing time of (48. 5 ± 4. 2) days,the difference between the two has statistical significance (P< 0. 01). In addition,compared with the control group,the healing time of the treat-ment group was significantly decreased,the difference was statistically significant ( P<0. 01 ) . Treatment group of 20 pa-tients had deep infection in 1 case and no osteomyelitis happened;treatment group 8 patients appeared in 4 cases of deep in-fection and osteomyelitis in 1 cases. Conclusion external fixation combined with vacuum sealing drainage ( VSD) tech-nique can effectively treat open fracture of tibia and fibula with soft tissue defect,in addition,it can also reduce the risk of complications.
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