Minimally invasive treatment combined with vacuum sealing drainage for open tibiofibular fractures based on staging strategy

WANG Hui; TAN Jia-chang; YANG You-meng; XU Hong-yu; JIANG Tie-bin

doi:10.3969/j.issn.1009-4237.2016.07.014

Abstract：Objective To investigate the curative effect of minimally invasive treatment combined with vac -uum sealing drainage for open tibiofibular fractures based on staging strategy .Methods Data of 60 patients with high-energy open tibiofibular fractures of Gustilo-ⅢA or ⅢB who were admitted from Mar .2010 to May 2014 was retrospectively analyzed.There were 32 males and 28 females,with age ranging from 18 to 65 years(average,30.6 years).Patients were treated with minimally invasive treatment combined with vacuum sealing drainage based on staging strategy.Stage I:radical debridement was applied;Kirschner wires,screws,wires or absorbable sutures were used to fix the fractures temporarily .Then,the vacuum sealing drainage was put on the surface of the open wound . Antibiotics were used to prevent infection after the surgery .One week later,the vacuum sealing drainage was re-moved to observe the situation of granulation tissue formation .The re-application of vacuum sealing drainage ,skin graft or skin flap transfer was performed based on the wound conditions .StageⅡ:locking compression plate or less invasive stabilization system ( LISS) plate was used for closed reduction and internal fixation with minimally invasive percutaneous plate osteosynthesis techniques .The curative effects and complications were observed and the indica-tions and treatment strategy for complications were analyzed .Furthermore ,all patients were followed up with a mini-mum of one year to observe the long-term effect . Results Minimally invasive treatment combined with vacuum sealing drainage for open fractures of tibia and fibula based on staging strategy has the advantages of shorter hospital stay,lower cost,less complications and faster fracture healing (average 7.2 months).Conclusion Minimally inva-sive treatment combined with vacuum sealing drainage for treating open fractures of tibia and fibula based on staging strategy is safe ,simple and applicable ,and it is worth promoting .