[Clinical observation of hidden tension suture with absorbable thread].
OBJECTIVE
To observe the operative technique and clinical effects of hidden tension suture after tibiofibular fracture fixation with absorbable thread.


METHODS
From October 2003 to October 2008, 203 patients (220 sides) with tibiofibular fracture underwent hidden tension suture (test group, 102 cases of 112 sides) and the common interrupted suture (control group, 101 cases of 108 sides), including 179 males and 24 females with an median age of 36 years (3-75 years). Fracture was caused by traffic accident in 170 cases, by heavy bruise in 21 cases, and by falling from height in 12 cases. There were 186 cases of single-side fracture, and 17 cases of double-side fracture. Of them, 127 sides were closed fracture, and 93 sides were open fracture (including 38 sides of type I, 45 sides of type II, and 10 sides of type IIIA according to Gustilo classification for the open fracture). The locations were upper tibia in 55 sides, middle tibia in 126 sides, and lower tibia in 39 sides. The X-ray films showed that there were transverse fractures in 65 sides, oblique fractures in 53 sides, spiral fractures in 45 sides, and comminuted fractures in 57 sides. No blood vessel injury, osteofascial compartment syndrome and pressure syndrome were observed. The time from injury to operation was 2 hours to 7 days with an average of 2 days. Of 220 sides, 45 sides were fixed by interlocking nails, others by internal steel plate.


RESULTS
In control group, healing by first intention was achieved in 70 cases (69.3%) and healing by secondary intention in 31 cases (30.7%); in test group, healing by first intention was achieved in 93 cases (91.2%) and healing by secondary intention in 9 cases (8.8%); and showing significant difference (P < 0.05). All patients were followed up for 6 months to 2 years (average 9 months). No complication occurred in test group, and scar was obvious in the control group.


CONCLUSIONS
The hidden tension suture with absorbable thread can be a good alternative for the incision healing after tibiofibular fracture fixation. It deals with the problems of the incision tension and difficult-to-suture, and is good for the incision healing after operation.
Peng
Jianqiang
J
Department of Orthopaedics, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen Guangdong, 518033, P.R. China. pengjq@live.cn
Hu
Mingshan
M
Zhou
Jingying
J
Lin
Kun
K
Huang
Aijun
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005360:Fibula / Q000293:injuries; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques; D013537:Sutures; D013978:Tibial Fractures / Q000601:surgery*; D055815:Young Adult