Papineau technique combined with vacuum-assisted closure for open tibial fractures: clinical outcomes at five years
Autor: | Xun Shu, Bao Tongzhu, Aixi Yu, Feng Xu, Baiwen Qi, Fang Han, Yi Yang, Ken Chen, Shijun Wei |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Tibia Fracture Bone grafting Fractures Open 03 medical and health sciences Postoperative Complications 0302 clinical medicine Negative-pressure wound therapy medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Tibia Retrospective Studies Wound Healing 030222 orthopedics Bone Transplantation Debridement business.industry Soft tissue Granulation tissue Length of Stay Middle Aged Combined Modality Therapy Surgery Tibial Fractures Treatment Outcome medicine.anatomical_structure Orthopedic surgery Female business Negative-Pressure Wound Therapy Follow-Up Studies |
Zdroj: | International Orthopaedics. 41:2389-2396 |
ISSN: | 1432-5195 0341-2695 |
Popis: | Treatment of open tibial fractures with soft tissue and segmental bone defects is difficult. This study reports our results for treating these injuries with a combination of Papineau open bone grafting and vacuum-assisted wound closure (VAC). The records of 19 patients with open tibial fractures with soft tissue and segmental bone defects treated with bone grafting and VAC from 2004 to 2010 were retrospectively reviewed. Outcomes included: time to complete granulation tissue coverage, wound healing, and bone union; length of hospitalization; frequency of debridement; number of deep tissue infections. Initial surgery was performed within 48 hours of injury. Ten fractures were Orthopaedic Trauma Association classification 41-A3, one was 41-C3, seven were 43-A3, and one was 43-C3. No surgical complications occurred, and the mean length of hospitalization was 11.0 ± 3.0 weeks (range, 7-18 weeks). The mean follow-up time was 59.35 ± 8.76 months. The mean time for complete wound healing was 7.76 ± 1.52 weeks (range, 6-11 weeks). Bone union was achieved in all patients at a mean of 33.88 ± 8.37 weeks (range, 23-53 weeks). Only one patient developed a deep tissue infection, which was treated with antibiotics and debridements, and complete bone union wound healing was achieved. Based on Paley grade, five outcomes were excellent, eight were good, and four were fair. The combination of VAC and open bone grafting results in good outcome for patients with open tibial fractures and severe bone and soft-tissue defects. |
Databáze: | OpenAIRE |
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