关键词: 负压封闭引流, 皮瓣转移术, Gustilo Ⅲ型胫腓骨骨折, 活性因子敷料, 骨折愈合

Abstract: Objective  To explore the application effect of negative pressure sealing drainage combined with active factor dressing and flap transfer in Gustilo Ⅲ type tibiofibular fractures.Methods  From March 2019 to March 2022,92 patients with Gustilo type Ⅲ tibiofibular fracture admitted to the Department of Orthopaedics of the Third People’s Hospital of Zhangjiagang City were randomly divided into the experimental group (internal and external fixation+flap transfer+negative pressure sealing drainage+active factor dressing,n=46) and the control group (internal and external fixation+flap transfer+conventional dressing change+active factor dressing,n=46),and the clinical indexes,clinical efficacy,ankle joint function,lower limb function and complications were compared.Result  The hospital stay time (25.32±8.36)d,the flap healing time (9.69±1.24)d,the fracture healing time (8.24±1.84)month and the wound healing time (14.24±3.84)d of the experimental group were shorter than those of the control group (43.44±11.84)d,(11.53±2.07)d and (9.12±2 .50) month,(50.11±5.12) d (P<0.05).The total effective rate of the experimental group (93.48%,43 cases /46 cases) was higher than that of the control group (71.74%,33 cases /46 cases,P<0.05).The ankle pain scores of both groups after treatment were lower than before treatment,and the experimental group was lower than the control group,and the scores of ankle function and stability,the scores of American Association of Foot and Ankle Surgery (AOFAS) and the knee joint score of American Hospital for Special Surgery (HSS) after treatment were higher in both groups than before treatment,and the experimental group was higher than the control group (P<0.05).The total complication rate of the experimental group (4.34%,2 cases /46 cases) was lower than that of the control group (17.39%,8 cases /46 cases,P<0.05).Conclusion  The application of negative pressure closed drainage combined with active factor dressing in Gustilo type Ⅲ tibia and fibula fracture is effective,can promote postoperative wound recovery,improve ankle and lower limb function,and the incidence of complications is low.

Key words: negative pressure closed drainage, flap transfer surgery, Gustilo type Ⅲ tibiofibular fracture, active factor dressing, fracture healing