Department of Military Medical Psychology, Air Force Military Medical University, No. 169 Changle Xi Road, Xi'an, Shaanxi Province, 710032, People's Republic of China.
Department of Orthopeadic Surgery, Xijing Hospital, Air Force Military Medical University, No. 127 Changle Xi Road, Xi'an, Shaanxi Province, 710032, People's Republic of China.
J Orthop Surg Res. 2021 May 27;16(1):340. doi: 10.1186/s13018-021-02479-2.
This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities.
The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed.
The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks.
The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.
本研究旨在回顾性分析一系列严重肢体开放性骨折（Gustilo IIIb 或 IIIc 型）患者的临床资料，这些患者通过根治性矫形外科手术获得了满意的结果，以期为严重肢体开放性骨折的治疗提供参考。
回顾性分析 2008 年 1 月至 2019 年 1 月期间连续 41 例接受成功的一期清创、固定和软组织重建的严重肢体开放性骨折（Gustilo IIIb 或 IIIc 型）患者的临床资料。通过定期随访获得术后指标，包括感染率和愈合时间，并进行分析。
患者的平均（±SD）年龄为 38 ± 16 岁。共分析了 90 例开放性骨折和严重软组织损伤。软组织覆盖在 72 小时内完成。总的感染率为 14.6%（6/41）。性别和四肢严重度评分与感染有关。40 例患者（1 例截肢）的中位愈合时间为 32 周。
与采用两阶段骨科方法治疗高分级开放性骨折的既往研究相比，本研究的总体感染率呈下降趋势。感染率和愈合时间的结果与既往研究相似。这些结果表明，一期根治性矫形外科治疗是重建严重肢体开放性骨折的有效可靠选择。
