Clinical Studyon Applying Locking Plate&VSD To Cure Gustilo ?? Bone Fractureatthe First Stage

BackgroundVacuum sealing drainage technology represented by VSD has been widely applied to surgery department of trauma.The technology has advantages over covering surface of a wound and relieving tissue edema in the open surface and promoting granulation as well as reducing possibility of wound infection.However,fixation that locking plates are applied to open fracture end can protect feeble blood supply of fracture end and also satisfy requirements of mechanical stability in fracture end,which is proved in the field of trauma orthopaedics.PurposeThe subject attempted to apply locking plate & VSD to cure gustilo?? open bone fracture at the first stage and combined the two advantages to increase clinical effects of the treatment efficiency of open fracture treatment and compared with clinical effects to cure open fracture of traditional first stage applying external fixator & VSD.MethodsLooking back 44 clinical data of Gustilo?? open bone fracture cured in Henan People's Hospital from January,2010 to January,2016,the application to locking plate &VSD to cure Gustilo?? bone fracture at the first stage(locking plate group)covered 21 cases including 21-case males and 8-case females.Their average age was 44.5 year-old.Follow-up period was 8-10 months and average period was 14.3 months.Two groups of patients had thorough debridement before operation and then gave different fixation for fracture end.Treated wounds of soft tissue at the second stage and then comparatively analyzed indexes between two groups postoperative complications(surface infection,deep inflection,malunion and fat embolism),fracture healing time,hospital stays,turn-off time of wound at the second stage and antibiotic expense.ResultsThe locking plate group covered 21 cases including 1 case postoperative surface inflection,1 case deep inflections,1 case malunion and 3 cases of fat embolism.The external fixation group covered 8 cases including 4 cases of surface inflection,4 cases of deep inflection,7 cases of malunion and no fat embolism.Two groups of patients had obvious difference of postoperative surface inflection rate(P=0.03<0.05),but had no obvious difference of postoperative complications.Postoperative fracture healing time of locking plate group was 18.6±1.8w,hospital stays 22.5±4.1d,turn-off time of wound at the second stage 6.3±1.6d and antibiotic expense 2290.09±257.10 RMB.Postoperative fracture healing time of external fixation groupwas 22±3.3w,hospital stays 27.6±7.8d,turn-off time of wound at the second stage 8.9±2.3d and antibiotic expense2611.82±489.58 RMB.Two groups of patients had obvious difference in fracture healing time,hospital stays,and antibiotic expense but had no statistics difference in turn-off time of wound at the second stage.ConclusionCompared with VSD of traditional external fixator combination,the application to locking plate & VSD to cure Gustilo?? bone fracture at the first stage can reduce postoperative surface inflection,shorten fracture healing time,lower hospital stays and antibiotic expense,which is an effective method to cure open fracture and is worthy of researching further clinical samples.