Tibial Nail Combined with Vacuum Sealing Drainage for Gustilo Grade IIIB Open Tibial Fractures: A Patient Series
Section snippets
Methods
The study was approved by the Yantaishan Hospital (Yantai, China) ethics committee, and informed consent was provided by all patients. Between March 2015 and March 2017, this study involved a consecutive series of 13 Gustilo grade IIIB open tibial fractures (all patients were males between 43 and 68 years of age) treated with ETNs and VSD. Exclusion criteria included autoimmunity, pathologic fractures, severe multiple trauma, blood disorders, or surgical contraindications. The causes of injury
Results
Values of outcome variables are shown in Table 1. All of these data suggested satisfactory postoperational patient health. The median physical functioning SF-36 score was 83.1 (range 72.5 to 93.0), and the median SF-36 mental score was 80.6 (range 69.7 to 92.0). The median AOFAS score was 93.7 (range 89 to 97), with all individuals having either excellent (90 to 100; n = 10, 76.9%) or good (80 to 89; n = 3, 23.1%) outcomes. Moreover, there were no instances of tibial shortening, neurovascular
Discussion
There remains controversy with regard to the best means of treatment for Gustilo grade III B open tibial fractures complicated by bone loss. Some work suggests that intramedullary nails may be the best means of stabilizing fractures associated with large segmental defects (11). The success of such an approach is dependent on the availability of sufficient healthy vascularized tissue to cover the wound site, to minimize the risk of complications including serious infection or malunion (12).
ETNs,
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