CAJ | 학술논문

目的：探讨分析VSD 联合锁定钢板内固定治疗胫腓骨GustiloⅡ、Ⅲ型骨折的临床疗效。方法选取2010年1月—2012年12月期间该院收治的50例胫腓骨GustiloⅡ、Ⅲ型骨折患者，均行急诊清创、VSD联合锁定钢板内固定治疗，持续负压引流7~10 d，伤口肉芽组织生长良好后行植皮或皮瓣修复创面。结果随访12~24个月，创面中完全愈合46例，4例患者创面依然存在坏死组织和渗出物；骨折骨性愈合48例，骨折延迟愈合2例，再行植骨术，骨折愈合。结论 VSD能够促进肉芽组织的生长，加速创面的愈合，降低伤口的感染率，缩短治疗时间，彻底清创后，采用VSD联合锁定钢板内固定治疗胫腓骨GustiloⅡ、Ⅲ型骨折是一种安全有效的治疗方法。
목적：탐토분석VSD 연합쇄정강판내고정치료경비골GustiloⅡ、Ⅲ형골절적림상료효。방법선취2010년1월—2012년12월기간해원수치적50례경비골GustiloⅡ、Ⅲ형골절환자，균행급진청창、VSD연합쇄정강판내고정치료，지속부압인류7~10 d，상구육아조직생장량호후행식피혹피판수복창면。결과수방12~24개월，창면중완전유합46례，4례환자창면의연존재배사조직화삼출물；골절골성유합48례，골절연지유합2례，재행식골술，골절유합。결론 VSD능구촉진육아조직적생장，가속창면적유합，강저상구적감염솔，축단치료시간，철저청창후，채용VSD연합쇄정강판내고정치료경비골GustiloⅡ、Ⅲ형골절시일충안전유효적치료방법。
Objective To observe the clinical effect of VSD combined with locking plate internal fixation on GustiloⅡ, Ⅲ frac-tures of tibia and fibula. Methods From January 2010 to December 2012, 50 patients with GustiloⅡ, Ⅲ fractures of tibia and fibula were treated by VSD combined with locking plate internal fixation after emergency debridement, and continuous negative pressure drainage for 7~10 d, and the wound was repaired by skin graft or skin flap when the granulation tissue grew well. Results All cases were followed up for 12 to 24 months, the wound of 46 cases healed completely, but that of 4 cases still had necrotic tis-sue and exudant; 48 cases had fracture bony union, but 2 cases underwent the second bone grafting surgery due to delayed frac-ture healing, and the fracture healed. Conclusion VSD can promote the growth of granulation tissues, quicken the wound healing, reduce the incidence of infection, and shorten the treatment time. After thorough debridement, VSD combined with locking plate internal fixation is a safe and effective treatment method for GustiloⅡ,Ⅲfractures of tibia and fibula.