急诊应用VSD与延期内固定治疗胫骨远端骨折的对比分析

目的：探讨严重胫骨远端骨折的临床治疗方案。方法：2008年2月至2011年2月我科治疗的106例严重胫骨远端骨折患者,84例急诊应用封闭负压引流术（vacuum sealing drainage,VSD）联合内固定治疗胫骨远端骨折（观察组）,22例延期应用内固定治疗胫骨远端骨折（对照组）,比较两组的住院天数、住院费用、术后并发症、术后疼痛程度评分。结果：两组在住院天数、住院费用的比较差异无统计学意义（P〉0.05）。观察组术后出现2例伤口裂开,疼痛程度评分为：（2.31±1.37）分,对照组出现3例伤口感染并裂开,疼痛程度评分为：（4.09±2.34）分。术后并发症、术后疼痛程度评分的比较差异有统计学意义（P〈0.05）。结论：急诊应用VSD联合内固定治疗胫骨远端骨折不增加患者的治疗费用,减少患者的痛苦,在临床上值得推广应用。

Comparison of Distal Tibial Fractures Treated with ORIF and VSD in Early Stage and after Improvement of Soft Tissue Conditions

Objective： To explore the clinical treatment of severe distal tibial fractures. Methods： 106 patients with severe distal tibial fractures were treated between February 2008 to February 2011.84 patients were treated by open reduction and intemal fixation （ORIF） with vacuum sealing drainage （VSD） in early stage, as study group. 22 patients were treated by ORIF after improvement of soft tissue conditions, as control group. Statistical analysis of days of hospital stay, hospital chargers, postoperative complication and postoperative pain scale were performed. Results： There was no significant difference between the two groups on days of hospital stay and hospital chargers （P〉0.05）. There were split of incision wound in 2 patients in study group and in 3 patients in control group. The postoperative pain scale was 2.31 ± 1.37 in study group and 4.09± 2.34 in control group. There was significant difference between them （P〈0.05）. Conclusion： The treatment of distal tibial fractures of OPRF and VSD in early stage had lower hospital chargers and reduced the pain of patients should be widely applied in clinical practice.