External fixators combined with continuous vacuum sealing drainage for treatment of open distal tibial fractures after Lushan earthquake

Abstract

Objective To investigate the clinical significance of external fixators combined with vacuum sealing drainage (VSD) in early treatment of open distal tibial fractures after Lushan earthquake.Methods The study involved 22 cases of severe open distal tibial fractures associated with soft tissue defects treated with external fixators combined with VSD in the early stage after Lushan earthquake.There were 9 males and 13 females,at age of 25-85 years (mean 42.6 years).Causes for the injury were hitting by heavy objects in 19 cases and fall from height in three cases.Gustilo classification of the open fracture were type Ⅱ in four cases,type ⅢA in six,type ⅢB in 10 and type ⅢC in two.Results Altogether,nine cases had regional skin grafting,11 flap transferring,two amputation.Seventeen cases were transformed to internal fixations within three weeks after the use of external fixators.Conclusions External fixators combined with VSD stabilize displaced fracture fragments rapidly and protect regional soft tissues.Simultaneously,continuous VSD closes wound cavity,reduces regional infection and stimulates wounds producing large amount of fresh granulation tissues over bone surface,which consequently wins time for skin grafting or regional flap transferring as well as creates a favorable condition for the ultimate conversion of external fixation to internal fixation and for the recovery of lower limb function. Key words: Tibia; Fractures, open ; External fixators