摘要
目的采用分期治疗的手段对临床上出现的严重开放性踝关节骨折进行治疗,探讨其临床疗效。方法对该科接诊的2016年1月—2018年3月的严重开放性踝骨折患者,一期急诊清创缝合有限内固定,负压封闭引流技术(VSD)覆盖创面,生理盐水冲洗并引流,二期创面环境良好时行切开复位内固定术。记录所有患者的住院时间、AOFAS评分、骨折愈合时间、并发症发生情况。结果 37例患者均获得随访,住院时间为10~17 d,平均住院时间(14.38±1.63)d;AOFAS评分为69~93分,平均分(82.77±1.21)分;骨折愈合时间为9~18周,平均愈合时间(13.41±1.15)周;一期:深部感染0例,表层皮缘感染2,抗生素+加强换药后恢复;皮缘处发黑3例,无特殊处理,5 d左右自己恢复。二期:仅有一例出现骨折延期愈合。结论分期治疗效果显著,踝关节恢复较好,骨折愈合时间与住院时间相对较短,值得临床推广使用。
Objective To investigate the clinical effect of staging treatment for severe open ankle fracture.Methods The patients with severe open ankle fractures admitted to our department from January 2016 to March 2018 were treated with first-stage emergency debridement suture limited internal fixation,negative pressure closed drainage technology(VSD)covering the wound surface,saline irrigation and drainage,and open reduction internal fixation when the wound environment was good in the second stage.Hospital stay,AOFAS score,fracture healing time and complications were recorded for all patients.Results All the 37 patients were followed up,and the length of stay was 10 to 17 days,with an average(14.38±1.63)d.AOFAS scores ranged from 69 to 93,with an average score of(82.77±1.21)points.The fracture healing time was 9 to 18 weeks,with an average(13.41±1.15)weeks.Phase I:0 cases of deep infection,2 cases of superficial skin edge infection,recovery after antibiotic+intensive dressing change;The skin margin blackened in 3 cases without special treatment and recovered by themselves after 5 d.Phase ii:only one patient had delayed fracture healing.Conclusion The effect of staged treatment is significant,the recovery of ankle joint is good,the time of fracture healing and hospitalization is relatively short,which is worthy of clinical application.
作者
王正波
曾升友
黄伟
WANG Zhengbo;ZENG Shengyou;HUANG Wei(Department of Orthopaedics and Traumatology,Luodian Hospital of Traditional Chinese Medicine,Luodian Guizhou,550100,China;Department 1,the Second Affiliated Hospital of Guiyang College of Traditional Chinese Medicine,Guiyang Guizhou,550001,China)
出处
《双足与保健》
2019年第13期143-144,共2页
Biped and Health
关键词
开放性踝关节骨折
负压封闭引流
分期手术
Open ankle fracture
Negative pressure sealed drainage
Staging surgery
